Individual
GRACE KIRIAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
604 EMPIRE ST FL 1, FAIRFIELD, CA 94533-5527
(707) 862-3872
Mailing address
2728 DURANT AVE, BERKELEY, CA 94704-1725
(510) 841-9230
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/13/2013
Last updated
09/15/2019
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