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Individual

DR. AMY GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
22622 VANOWEN ST, WEST HILLS, CA 91307-2646
(919) 464-3333
(818) 464-3249
Mailing address
4301 NOGALES DR, TARZANA, CA 91356-5117
(818) 705-5639

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY11189
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY11189
PSYCHOLOGIST LICENSE
CA
Enumeration date
07/13/2006
Last updated
07/08/2007
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