Individual
MR. ANDREW STAN GRUCHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
850 E FOOTHILL BLVD, RIALTO, CA 92376-5230
(909) 421-9410
Mailing address
7031 ELBURN CT, ALTA LOMA, CA 91701-6080
(909) 421-9410
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 14344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS 14344
LIC. CLINICAL SOCIAL WORH
CA
Enumeration date
02/05/2007
Last updated
07/08/2007
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