Provider Information for 1366569394
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GREGG VONFEMPE LCSW
Sex: Male
NPI: 1366569394
Last Updated: 2014-07-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1366569394 | ||||||||||||
| Enumeration Date | 2007-03-23 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 825 E ORANGE GROVE BLVD PASADENA, CA 91104-1160 United States Phone: 626-240-4550 | Fax: | ||||||||||||
| Primary Practice Address | 825 E ORANGE GROVE BLVD PASADENA, CA 91104-1160 United States Phone: 626-240-4550 | Fax:626-798-2397 | ||||||||||||
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