Provider Demographics
NPI:1871921239
Name:ENGLISH, GREGORY VASHON (MCET)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:VASHON
Last Name:ENGLISH
Suffix:
Gender:M
Credentials:MCET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 SPRUCE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2337
Mailing Address - Country:US
Mailing Address - Phone:951-782-0575
Mailing Address - Fax:
Practice Address - Street 1:1735 SPRUCE ST
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2337
Practice Address - Country:US
Practice Address - Phone:951-782-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation