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Individual

GRAYSON JAMES LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
1950 S SUNWEST LN, SAN BERNARDINO, CA 92408-3258
(909) 252-4010
Mailing address
1305 TOMMYDON ST, STOCKTON, CA 95210-3364
(209) 476-3341
(209) 476-3528

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY32222
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/27/2015
Last updated
02/11/2022
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