Individual
GRANT GAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2275 ARLINGTON DR, SAN LEANDRO, CA 94578-1132
(510) 317-1444
Mailing address
2275 ARLINGTON DR., SAN LEANDRO, CA 94578
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/25/2013
Last updated
04/13/2015
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