Individual
CALLIE GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1340 TULLY RD., 304, SAN JOSE, CA 95122
(408) 271-3960
(408) 271-3909
Mailing address
40 TULLY RD., 304, SAN JOSE, CA 95122
(408) 271-3960
(408) 271-3909
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-G1307201216
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI-G1307201216
RASI
CA
Enumeration date
12/26/2014
Last updated
12/26/2014
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