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General NPI Number Information
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NPI Number | 1467855379
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Entity Type | Individual
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Provider Name | TRUITT GRANT LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 339 PAJARO ST STE D
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City | SALINAS
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State | CA
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Zip | 93901-3400
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Country | US
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Telephone | 831-883-8030
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 541
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City | SEASIDE
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State | CA
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Zip | 93955-0541
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Country | US
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Telephone | 831-747-4286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 98967
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License Number State | CA
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