Provider Demographics
NPI:1770730269
Name:BRAY, JAMES RICHARD
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:BRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 S DODSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4025
Mailing Address - Country:US
Mailing Address - Phone:310-514-9241
Mailing Address - Fax:
Practice Address - Street 1:2330 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2220
Practice Address - Country:US
Practice Address - Phone:213-342-3114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor