Provider Demographics
NPI:1477674034
Name:GRUSKA, JANIS KATHLEEN (ND)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:KATHLEEN
Last Name:GRUSKA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18723 VIA PRINCESSA # 423
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-4954
Mailing Address - Country:US
Mailing Address - Phone:310-270-3107
Mailing Address - Fax:
Practice Address - Street 1:4110 SORRENTO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1429
Practice Address - Country:US
Practice Address - Phone:858-246-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-99175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath