Provider Demographics
NPI:1952321119
Name:GREY, HOWARD A (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:A
Last Name:GREY
Suffix:
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 1:32100 OAKSHORE DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3808
Mailing Address - Country:US
Mailing Address - Phone:818-865-8383
Mailing Address - Fax:818-774-1935
Practice Address - Street 1:18740 VENTURA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3366
Practice Address - Country:US
Practice Address - Phone:818-774-0451
Practice Address - Fax:818-774-1935
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 552106H00000X
CASP 942235Z00000X
CAAUD 66231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist