Provider Demographics
NPI:1659585180
Name:MCGREGOR, FLOYD A JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:A
Last Name:MCGREGOR
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8726 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE D #A131
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-4023
Mailing Address - Country:US
Mailing Address - Phone:323-309-7708
Mailing Address - Fax:818-781-2389
Practice Address - Street 1:14724 VENTURA BLVD
Practice Address - Street 2:STE. 1100
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3501
Practice Address - Country:US
Practice Address - Phone:818-995-8292
Practice Address - Fax:818-986-0724
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical