Individual provider Active NPI

Cheryl Deborah Grant, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1295895043
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35887 Issued in CA
Practice address
2211 Corinth Ave
Suite 203
Los Angeles, CA 90064-1650
Phone
(310) 268-2200
Fax
(310) 268-2200
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35887 CA Primary

Addresses

Primary practice location

2211 Corinth Ave
Suite 203
Los Angeles, CA 90064-1650

Mailing address

2211 Corinth Ave
Suite 203
Los Angeles, CA 90064-1650
Phone (310) 268-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35887CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1295895043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 CORINTH AVE",
            "address_2": "SUITE 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641650",
            "telephone_number": "310-268-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 CORINTH AVE",
            "address_2": "SUITE 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641650",
            "telephone_number": "310-268-2200",
            "fax_number": "310-268-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "CHERYL",
        "middle_name": "DEBORAH",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "35887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.