Provider Demographics
NPI:1265864326
Name:GRIER, ALFRED LAYTON JR (RAS)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:LAYTON
Last Name:GRIER
Suffix:JR
Gender:M
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 SONOMA OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-9494
Mailing Address - Country:US
Mailing Address - Phone:323-632-7476
Mailing Address - Fax:
Practice Address - Street 1:14320 PALM DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6874
Practice Address - Country:US
Practice Address - Phone:760-770-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1207252021101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)