Provider Demographics
NPI:1366020240
Name:GREG WESTERN AND ASSOCIATES PSYCHOTHERAPY, PC
Entity Type:Organization
Organization Name:GREG WESTERN AND ASSOCIATES PSYCHOTHERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WESTERN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:714-420-7378
Mailing Address - Street 1:5101 E LA PALMA AVE STE 100L
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2056
Mailing Address - Country:US
Mailing Address - Phone:714-420-7378
Mailing Address - Fax:
Practice Address - Street 1:5101 E LA PALMA AVE STE 100L
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2056
Practice Address - Country:US
Practice Address - Phone:714-420-7378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health