Provider Demographics
NPI:1487432134
Name:GREVER, TIMOTHY V
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:V
Last Name:GREVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 FAVIER DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8394
Mailing Address - Country:US
Mailing Address - Phone:209-355-3689
Mailing Address - Fax:
Practice Address - Street 1:1101 M ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0755
Practice Address - Country:US
Practice Address - Phone:209-522-9568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist