Grace, James A

Grace, James A is an individual health care provider with primary practice located at 10630 Town Center Drive Suite #124, Rancho Cucamonga CA 91730. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Grace, James A can be contacted via phone (909) 949-6011.

Contact Information

Primary practice address
10630 Town Center Drive Suite #124 Rancho Cucamonga CA 91730
Phone: (909) 949-6011
Fax: (909) 948-8899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY12929 California

Profile Details

NPI number 1396801304
LBN Legal business name Grace, James A
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396801304 NPPES
California MEDICAID PSY12929

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