Provider Demographics
NPI:1487823167
Name:GRAY, FRANK L JR
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:L
Last Name:GRAY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BRYN MAWR DR
Mailing Address - Street 2:# B
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-1833
Mailing Address - Country:US
Mailing Address - Phone:415-459-4953
Mailing Address - Fax:415-519-4253
Practice Address - Street 1:914 MISSION AVE FL 3
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-6106
Practice Address - Country:US
Practice Address - Phone:415-457-6964
Practice Address - Fax:415-721-0281
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health