Koch, Gregory Ernest
Koch, Gregory Ernest is an sole proprietor health care provider with primary practice located at 4081 Stephens St , San Diego CA 92103-1242. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Koch, Gregory Ernest can be contacted via phone (888) 588-7836.Contact Information
Primary practice address
4081 Stephens St
San Diego CA 92103-1242
Phone: (888) 588-7836
Fax: (888) 588-7836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | PSY19917 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY19917 | California |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | PSY19917 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY19917 | California |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | PSY19917 | California |
Profile Details
| NPI number | 1730180852 |
|---|---|
| LBN Legal business name | Koch, Gregory Ernest |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730180852 | NPPES |
| California | Other | 0PL199170 | BLUE SHIELD |
| California | Other | 11397904 | BLUE SHIELD |
| California | MEDICAID | PSY199170 | BLUE SHIELD |
| California | Other | 5551998 | BLUE SHIELD |
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