Active NPI
Justin Dorian Grey, MD
- Psychiatry Physician
- San Jose, CA
National Provider Identifier
1992898753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G65957
- Practice address
- 2001 The Alameda
Alliance for Community Care
San Jose, CA 95126-1136 - Phone
- (408) 261-7777
- Fax
- (408) 554-9960
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | G65957 | CA | |
| Psychiatry Physician | 2084P0800X | G65957 | CA | Primary |
| Addiction Psychiatry Physician | 2084P0802X | G65957 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | G65957 | CA | |
| Geriatric Psychiatry Physician | 2084P0805X | G65957 | CA |
Addresses
Primary practice location
2001 The Alameda
Alliance for Community Care
San Jose, CA 95126-1136
Mailing address
2001 The Alameda
Alliance for Community Care
San Jose, CA 95126-1136
Phone (408) 261-7777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G659571 | Other | PPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G65957 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1992898753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 THE ALAMEDA",
"address_2": "ALLIANCE FOR COMMUNITY CARE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261136",
"telephone_number": "408-261-7777",
"fax_number": "408-554-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 THE ALAMEDA",
"address_2": "ALLIANCE FOR COMMUNITY CARE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261136",
"telephone_number": "408-261-7777",
"fax_number": "408-554-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREY",
"first_name": "JUSTIN",
"middle_name": "DORIAN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "CA",
"license": "G65957",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G65957",
"primary": true
},
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "CA",
"license": "G65957",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "G65957",
"primary": false
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "CA",
"license": "G65957",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "00G659571",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.