Provider Demographics
NPI:1508422544
Name:GREGORY, AMIRA ZSADEE (ACSW)
Entity Type:Individual
Prefix:
First Name:AMIRA
Middle Name:ZSADEE
Last Name:GREGORY
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 E RING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3154
Mailing Address - Country:US
Mailing Address - Phone:562-607-7803
Mailing Address - Fax:
Practice Address - Street 1:4076 17TH ST APT C
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1993
Practice Address - Country:US
Practice Address - Phone:212-655-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA987061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical