Individual ProviderMichael Douglas GrubbCounselorBehavioral Health & Social Service ProvidersPractice Address390 40th St, Oakland, CA 94609-2633(510) 653-5040PECOS EnrollmentBased on the most recent information from CMS, provider Michael Douglas Grubb does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1629301221Provider TypeIndividualFull NameGrubb, Michael DouglasGenderMaleSole ProprietorNoEnumeration Date9/14/2009Last Updated10/3/2014Contact InformationPractice LocationPractice Address390 40th St, Oakland, CA 94609-2633Phone(510) 653-5040Fax(510) 653-6475Mailing LocationMailing Address390 40th St, Oakland, CA 94609-2633Phone(510) 653-5040Fax(510) 653-6475Provider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer