Provider Demographics
NPI:1073707451
Name:GREFENSON, ALICIA MARIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MARIS
Last Name:GREFENSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 CAMINO DIABLO FL 3
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-4001
Mailing Address - Country:US
Mailing Address - Phone:925-360-5264
Mailing Address - Fax:
Practice Address - Street 1:2970 CAMINO DIABLO FL 3
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-4001
Practice Address - Country:US
Practice Address - Phone:925-360-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA31315103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health