DR. JACQUELINE MARY GRAY PH.D.
NPI 1124066725
Psychologist in Los Alamitos, CA

Active since June 03, 2006Opted out of Medicare · through Jan 1, 2027
5212 KATELLA AVE, SUITE #202, LOS ALAMITOS, CA 90720(562) 493-0933(562) 493-0922 Get Directions Write a Review

NPPES record last updated: March 14, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jacqueline Mary Gray Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE MARY GRAY PH.D. (NPI 1124066725) is an individual psychologist in Los Alamitos, California, licensed in California (PSY11186) and active in the NPI registry since June 2006. She has opted out of Medicare through January 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124066725
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JACQUELINE MARY GRAYCredential: PH.D.
Location Address5212 KATELLA AVE, SUITE #202Los Alamitos, CA 90720-2828
Mailing AddressPo Box 1173Los Alamitos, CA 90720-1173 · (562) 493-0933 · Fax (562) 493-0922
Fax(562) 493-0922
Sole ProprietorYes
Enumeration DateJune 3, 2006
Last NPPES UpdateMarch 14, 2018
NPI 1124066725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY11186
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
5212 KATELLA AVE, Los Alamitos, CA 90720

Other Identifiers 1

Other542200PL111861CA · Blue Shield Provider

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Jacqueline Mary Gray Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2017 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2017
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
5212 KATELLA AVE, STE. 106
LOS ALAMITOS, CA 90720
Psychologist (Clinical)
5212 KATELLA AVE, SUITE #202
LOS ALAMITOS, CA 90720
Marriage & Family Therapist
5212 KATELLA AVE, SUITE 101
LOS ALAMITOS, CA 90720
Marriage & Family Therapist
5212 KATELLA AVE, SUITE 101
LOS ALAMITOS, CA 90720
Psychologist
5212 KATELLA AVE, SUITE 104
LOS ALAMITOS, CA 90720
Psychologist (Clinical)
5212 KATELLA AVE, SUITE 202
LOS ALAMITOS, CA 90720
Clinic/Center (Mental Health (Including Community Mental Health Center))
5212 KATELLA AVE, SUITE 106
LOS ALAMITOS, CA 90720

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Gray's NPI number?

The NPI number for Jacqueline Gray is 1124066725. It was assigned to this individual provider in the NPPES registry on June 3, 2006.

Where is Jacqueline Gray located?

Jacqueline Gray practices at 5212 Katella Ave Suite #202, Los Alamitos, CA 90720. The listed phone number is (562) 493-0933.

What is Jacqueline Gray's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jacqueline Gray enrolled in Medicare?

No. Jacqueline Gray has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jacqueline Gray was last updated on March 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.