Individual provider Active NPI

Justin Dorian Grey, MD

  • Psychiatry Physician
  • San Jose, CA
National Provider Identifier
1992898753
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G65957 Issued in CA
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

Updated by the provider on Mar 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00G659571OtherPPIN

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

LicenseStateTypeSpecialty
G65957CAMDChild & 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

Verify at the official NPI Registry.