Porsha K Gray, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95020006 Issued in CA

Practice address

506 W Jackman St
Lancaster, CA 93534-2531

Phone

(661) 802-1467

NPI assigned

Apr 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health America of Los AngelesGroup PAC ID 1759419997, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health America of Los Angeles

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1003138009
  Medicare reassignment Care Compare group
• Mental Health America of Los Angeles

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1104942044
  NPD
• Mental Health America of Los Angeles

  • Community/Behavioral Health Agency
  • Lancaster, CA
  • NPI 1578689402
  NPD
• Pasadena Clinical Group, a Psychology Corporation

  • Psychologist
  • Pasadena, CA
  • NPI 1790213247
  NPD

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1346981750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16145 APRICOT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917088875",
            "telephone_number": "310-346-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W JACKMAN ST",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342531",
            "telephone_number": "661-802-1467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 E Colorado Blvd Fl 9",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911012193",
            "country_code": "US",
            "telephone_number": "657-204-6014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "PORSHA",
        "middle_name": "K",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95020006",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Granger
• Carol Louise Granlund, PSY.D.
• Carol Luisa Grant-Dougherty, P.A.
• Terrill Grant
• Amanda Jo Graves, RN, MSN
• William Gray
• Judith Lynn Grayson
• Letha Grayson, PSY.D , LADAC
• Denise Green
• Jewellius Orryon Green

• Psychiatric/Mental Health Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.