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PHINNILLIPA DEGRUY
>> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1124221643
Individual Registrant: PHINNILLIPA DEGRUY
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
127 GRENADINE WAY HERCULES, CA 94547-2041 US
Tel: 510-799-1570 Fax: 510-799-1866
Tel: 510-799-1570 Fax: 510-799-1866
Contact information for business:
1901 CHURCH LN SAN PABLO, CA 94806-3707 US
Tel: 510-236-3139 Fax: 510-236-3200
Tel: 510-236-3139 Fax: 510-236-3200
Registration Information:
NPI: 1124221643
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101Y00000X | Behavioral Health & Social Service Providers Counselor |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
