Provider Demographics
NPI:1427842970
Name:MITRO, GREER
Entity type:Individual
Prefix:
First Name:GREER
Middle Name:
Last Name:MITRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27702 CROWN VALLEY PKWY
Mailing Address - Street 2:STE. D4 #1027
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694
Mailing Address - Country:US
Mailing Address - Phone:949-547-1360
Mailing Address - Fax:
Practice Address - Street 1:97 BACULO ST
Practice Address - Street 2:
Practice Address - City:RANCHO MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92694-1395
Practice Address - Country:US
Practice Address - Phone:949-547-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148801106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist