Provider Demographics
NPI:1184157364
Name:JANET GREGORY, PHD
Entity type:Organization
Organization Name:JANET GREGORY, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-681-6862
Mailing Address - Street 1:529 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2599
Mailing Address - Country:US
Mailing Address - Phone:415-681-6862
Mailing Address - Fax:415-206-9230
Practice Address - Street 1:529 IRVING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2599
Practice Address - Country:US
Practice Address - Phone:415-681-6862
Practice Address - Fax:415-206-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5674103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty