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General NPI Number Information
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NPI Number | 1831304229
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Entity Type | Organization
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Legal Business Name | DIANA M. GREG, PH.D, INC.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8950 VILLA LA JOLLA DR SUITE B208
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City | LA JOLLA
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State | CA
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Zip | 92037-1714
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Country | US
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Telephone | 858-552-1559
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Fax | 858-552-1502
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Provider Business Mailing Address
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Address Line | 8950 VILLA LA JOLLA DR B208
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City | LA JOLLA
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State | CA
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Zip | 92037-1714
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Country | US
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Telephone | 858-552-1559
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Fax | 858-552-1502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANA M. GREG
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Credential | PH.D
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Telephone | 858-552-1559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 18346
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License Number State | CA
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