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General NPI Number Information
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NPI Number | 1972014819
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Entity Type | Organization
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Legal Business Name | DANA GRIP, PSYCHOLOGIST, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2512 FOOTHILL BLVD
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3506
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Country | US
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Telephone | 818-927-1743
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 752
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City | VERDUGO CITY
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State | CA
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Zip | 91046-0752
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Country | US
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Telephone | 818-927-1743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANA RICHARDSON GRIP
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Credential | PH.D.
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Telephone | 818-927-1743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY29379
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License Number State | CA
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