Provider Demographics
NPI:1952745861
Name:GROW, ADRIAN SAUL
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:SAUL
Last Name:GROW
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 1:1221 E DYER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5634
Mailing Address - Country:US
Mailing Address - Phone:949-250-0488
Mailing Address - Fax:
Practice Address - Street 1:1221 E DYER RD STE 120
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5634
Practice Address - Country:US
Practice Address - Phone:949-250-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor