Individual
KEVIN VALON GRUENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6310 SAN VICENTE BLVD STE 415, LOS ANGELES, CA 90048-5457
(310) 601-6417
Mailing address
6310 SAN VICENTE BLVD STE 415, LOS ANGELES, CA 90048-5457
(310) 601-6417
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY29678
CA
Other
Enumeration date
09/12/2012
Last updated
03/17/2018
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