Individual
INGRID M GRANADOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 SMITH RANCH RD, SAN RAFAEL, CA 94903-1939
(415) 491-3000
Mailing address
3426 LOWELL AVE, RICHMOND, CA 94804-1168
(415) 602-4477
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2020
Last updated
09/13/2024
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