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General NPI Number Information
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NPI Number | 1699927459
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Entity Type | Individual
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Provider Name | KYM G. GREY LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 1300 RANCHO DEL ORO RD. SUITE 1J-1I3
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City | OCEANSIDE
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State | CA
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Zip | 92056
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Country | US
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Telephone | 760-643-2086
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Fax | 760-643-2096
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Provider Business Mailing Address
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Address Line | PO BOX 521
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City | SAN MARCOS
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State | CA
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Zip | 92079
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Country | US
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Telephone | 760-908-7165
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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 | 24206
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License Number State | CA
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