MEDICARE: DR. JAYCE GREGG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1659152379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYCE GREGG

Provider Business Mailing Address
First Line	:	1861 N SPRING APT 102
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-9605
Country	:	US
Telephone Number	:	602-600-1265
Fax Number	:

Provider Business Practice Location Address
First Line	:	1861 N SPRING APT 102
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-9605
Country	:	US
Telephone Number	:	602-600-1265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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Directions to “ DR. JAYCE GREGG ” Practice Location

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