Provider Demographics
NPI:1770168825
Name:GRAY, GEMMA (AUD)
Entity type:Individual
Prefix:MRS
First Name:GEMMA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7363 CELATA LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4552
Mailing Address - Country:US
Mailing Address - Phone:760-331-9317
Mailing Address - Fax:
Practice Address - Street 1:7363 CELATA LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4552
Practice Address - Country:US
Practice Address - Phone:760-331-9317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3579231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist