Provider Demographics
NPI:1619759867
Name:GRAY, SANTY
Entity Type:Individual
Prefix:
First Name:SANTY
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2225
Mailing Address - Country:US
Mailing Address - Phone:530-715-9611
Mailing Address - Fax:530-466-3154
Practice Address - Street 1:19 WILLIAMSBURG LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2225
Practice Address - Country:US
Practice Address - Phone:530-715-9611
Practice Address - Fax:530-466-3154
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health