Gray, Susan Genevieve

Gray, Susan Genevieve is an sole proprietor health care provider with primary practice located at 3186 Airway Ave , Costa Mesa CA 92626-4650. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as her primary health care specialty. Gray, Susan Genevieve can be contacted via phone (469) 938-9987.

Contact Information

Primary practice address
3186 Airway Ave Costa Mesa CA 92626-4650
Phone: (469) 938-9987
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1083306948
LBN Legal business name Gray, Susan Genevieve
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 22nd, 2023
Last updated May 22nd, 2023 - about 2 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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