Provider Demographics
NPI:1265211908
Name:GRIT PSYCHOLOGICAL SOLUTIONS, PC
Entity type:Organization
Organization Name:GRIT PSYCHOLOGICAL SOLUTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:909-438-8392
Mailing Address - Street 1:2910 S ARCHIBALD AVE.
Mailing Address - Street 2:SUITE A, #139
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7358
Mailing Address - Country:US
Mailing Address - Phone:909-438-8392
Mailing Address - Fax:
Practice Address - Street 1:2003 E CHERRY HILL CT
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761
Practice Address - Country:US
Practice Address - Phone:909-438-8392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty