Individual
GREGORY DIEHL CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3350 SHELBY ST STE 200, ONTARIO, CA 91764-5556
(909) 935-2385
(909) 935-2685
Mailing address
3350 SHELBY ST STE 200, ONTARIO, CA 91764-5556
(909) 935-2385
(909) 935-2685
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY28640
CA
103T00000X
Psychologist
PSY28640
CA
103TC0700X
Clinical Psychologist
28640
CA
Other
Enumeration date
06/11/2012
Last updated
04/02/2021
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