Provider Demographics
NPI:1215683677
Name:GREVIOUS, CHIOKO JULIETTE (LMFT)
Entity type:Individual
Prefix:
First Name:CHIOKO
Middle Name:JULIETTE
Last Name:GREVIOUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221336
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-8336
Mailing Address - Country:US
Mailing Address - Phone:916-639-9274
Mailing Address - Fax:
Practice Address - Street 1:6884 23RD ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4142
Practice Address - Country:US
Practice Address - Phone:916-764-8951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127290101YM0800X
CA140786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health