Provider Demographics
NPI:1285872895
Name:CARINCI, GREGORY J (PSYD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:CARINCI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8031 CAMINITO DE PIZZA UNIT E
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1408
Mailing Address - Country:US
Mailing Address - Phone:858-414-6830
Mailing Address - Fax:
Practice Address - Street 1:591 CAMINO DE LA REINA STE 821
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3110
Practice Address - Country:US
Practice Address - Phone:858-414-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1084607103K00000X
CAPSY 22311103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst