Individual
JOSEPH GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
215 W BEAMER ST, WOODLAND, CA 95695-2510
(530) 759-3136
Mailing address
3939 MADISON AVE APT 256, NORTH HIGHLANDS, CA 95660-6319
(530) 908-1507
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-NIDMLU
CA
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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