Individual
MR. MITCHELL LEE GRESHAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4660 PALM AVE, SAN DIEGO, CA 92154-8404
(183) 357-9484
Mailing address
4660 PALM AVE, SAN DIEGO, CA 92154-8404
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5250
CA
101YP2500X
Professional Counselor
Primary
21573
CA
101YP2500X
Professional Counselor
Primary
5250
CA
Other
Enumeration date
01/08/2019
Last updated
02/04/2026
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