Active NPI
Roxana G. Gravelle, L. AC.
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1265860340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 15150
- Practice address
- 12568 W Washington Blvd
Los Angeles, CA 90066-5521 - Phone
- (424) 888-0339
- NPI assigned
- Oct 28, 2013
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 15150 | CA | Primary |
Addresses
Primary practice location
12568 W Washington Blvd
Los Angeles, CA 90066-5521
Mailing address
4742 Halbrent Ave
Sherman Oaks, CA 91403-2420
Phone (310) 909-4779
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": "1382918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382918400000",
"number": "1265860340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4742 HALBRENT AVE",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914032420",
"telephone_number": "310-909-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12568 W WASHINGTON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665521",
"telephone_number": "424-888-0339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVELLE",
"first_name": "ROXANA",
"middle_name": "G.",
"credential": "L. AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-28",
"last_updated": "2013-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "15150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.