Provider Demographics
NPI:1265556286
Name:MOEHN GRENEVITCH, RYANN (LMFT)
Entity type:Individual
Prefix:
First Name:RYANN
Middle Name:
Last Name:MOEHN GRENEVITCH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202-A ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-2300
Mailing Address - Country:US
Mailing Address - Phone:619-431-5049
Mailing Address - Fax:
Practice Address - Street 1:4204A ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-2300
Practice Address - Country:US
Practice Address - Phone:619-431-5049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43558106H00000X
CAMFT43558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist