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Individual

GREGORY JEFFERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1811 W 41ST DR, LOS ANGELES, CA 90062-1517
(323) 725-4439
Mailing address
1811 W 41ST DR, LOS ANGELES, CA 90062-1517
(323) 725-4439

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
CA
225400000X
Rehabilitation Practitioner
Primary
CA

Other

Enumeration date
07/16/2024
Last updated
04/30/2025
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