Active NPI
Patricia Alvarez Grube, CCBD
- Doula
- Redondo Beach, CA
National Provider Identifier
1184959751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 6726
- Practice address
- 1630 Goodman Ave
Redondo Beach, CA 90278-2719 - Phone
- (310) 749-2636
- NPI assigned
- Oct 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | 6726 | CA | Primary |
Addresses
Primary practice location
1630 Goodman Ave
Redondo Beach, CA 90278-2719
Mailing address
1630 Goodman Ave
Redondo Beach, CA 90278-2719
Phone (310) 749-2636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374J00000X | Other | CA | DONT UNDERSTAND THIS QUESTION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6726 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255478400000",
"number": "1184959751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 GOODMAN AVE",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902782719",
"telephone_number": "310-749-2636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 GOODMAN AVE",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902782719",
"telephone_number": "310-749-2636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBE",
"first_name": "PATRICIA",
"middle_name": "ALVAREZ",
"credential": "CCBD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-14",
"last_updated": "2009-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "CA",
"license": "6726",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DONT UNDERSTAND THIS QUESTION",
"identifier": "374J00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.