Provider Demographics
NPI:1861974800
Name:HUGH GRUBB PSYD MFT INC.
Entity type:Organization
Organization Name:HUGH GRUBB PSYD MFT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUBB
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:408-395-7592
Mailing Address - Street 1:301 LOS GATOS SARATOGA RD STE B
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5327
Mailing Address - Country:US
Mailing Address - Phone:408-395-7592
Mailing Address - Fax:
Practice Address - Street 1:301 LOS GATOS SARATOGA RD STE B
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5327
Practice Address - Country:US
Practice Address - Phone:408-395-7592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT27627102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty