Individual
MALLORY ELLEN DEGRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 SCHRADER BLVD, LOS ANGELES, CA 90028-6213
(323) 993-7500
Mailing address
1625 SCHRADER BLVD, LOS ANGELES, CA 90028-6213
(323) 993-7500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95020327
CA
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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