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Dazie Rustin Grego
Peer Specialist in Oakland, California
NPI 1629832712

Dazie Rustin Grego is a Peer Specialist based in Oakland, CA. Dazie Rustin Grego practices in Oakland, CA. The NPI Number for Dazie Rustin Grego is 1629832712 and holds a License No. (California).

The current practice location address for Dazie Rustin Grego is 629 Oakland Ave, Oakland, CA and can be reached out via phone at 510-658-9480.

Location: 629 Oakland Ave, Oakland, CA, 94609-2633
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629832712
Provider Name
Dazie Rustin Grego
Credential
Provider Entity Type
Individual
Gender
Male
Address
629 Oakland Ave, Oakland, CA, 94609-2633
Phone Number
510-658-9480
Fax Number
Provider Enumeration Date
02/08/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
629 Oakland Ave
City
Oakland
State
California
Zip
94611-4567
Phone Number
510-658-9480
Fax Number
person
Provider Business Mailing Address Details
Address
629 Oakland Ave
City
Oakland
State
California
Zip
94611-4567
Phone Number
510-658-9480
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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