Individual provider Active NPI

Pamela Vernell Grimm

  • Addiction (Substance Use Disorder) Counselor
  • San Francisco, CA
National Provider Identifier
1013068543
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
333 Valencia St
#222
San Francisco, CA 94103-3547
Phone
(415) 864-2364
Fax
(415) 864-0116
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

333 Valencia St
#222
San Francisco, CA 94103-3547

Mailing address

3400 Richmond Pkwy
#2421
Richmond, CA 94806-5207
Phone (510) 222-1378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1013068543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 RICHMOND PKWY",
            "address_2": "#2421",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948065207",
            "telephone_number": "510-222-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 VALENCIA ST",
            "address_2": "#222",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941033547",
            "telephone_number": "415-864-2364",
            "fax_number": "415-864-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "PAMELA",
        "middle_name": "VERNELL",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.