Grayson Wallen (NPI# 1962007369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1962007369 |
| Entity Type | Individual |
| Full Name | Grayson Wallen |
| Credential | PCC |
| Gender | Male |
| Practice Address |
4025 Camino Del Rio S # 250a San Diego CA 92108-4107 |
| Practice Telephone | 6198583105 |
| Mailing Address |
2909 Cowley Way Unit L San Diego CA 92117-6818 |
| Mailing Telephone | 4802348363 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2020-12-02 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 101YP2500X | Counselor · Professional | Behavioral Health & Social Service Providers | 5227 | CA |
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457955387 | Rene John Molenkamp | Counselor | 4323 Santa Monica Ave, San Diego, CA 92107-2930 | 2020-11-22 |
| 1720606221 | Jennifer Bohan | Counselor | 9889 Scripps Westview Way Unit 204, San Diego, CA 92131-2426 | 2020-07-10 |
| 1518587906 | Dong-ru Ho | Counselor | 13015 Evening Creek Dr S Unit 17, San Diego, CA 92128-8114 | 2020-04-25 |
| 1023659679 | Amy Abbasov | Counselor | 10232 Camino Ruiz Apt 108, San Diego, CA 92126-6458 | 2019-10-04 |
| 1255990347 | Pilar Marie Placone | Counselor | 3356 2nd Ave Ste A1, San Diego, CA 92103-5636 | 2019-06-12 |
| 1265099055 | Emily Duval | Counselor | 4519 Idaho St Unit 6, San Diego, CA 92116-3175 | 2019-05-28 |
| 1194230078 | Nnamdi Rashid Okafor | Counselor | 9606 Tierra Grande St Ste 207, San Diego, CA 92126-6501 | 2017-12-13 |
| 1275074379 | Rachel Gabrielle Packer | Counselor | 5252 Balboa Ave Ste 801, San Diego, CA 92117 | 2017-03-09 |
| 1396100442 | Sylvia Vella | Counselor | 1455 Frazee Rd, Suite 500, San Diego, CA 92108-4301 | 2015-12-16 |
| 1376985788 | Lauren Stern | Counselor | 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101-1253 | 2013-07-26 |
| Find all providers in SAN DIEGO | ||||
| Street Address |
4025 CAMINO DEL RIO S # 250A |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.