Gloria Mae Graham, SUDCC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11499 Issued in CA

Practice address

2535 Camino del Rio S Ste 100
San Diego, CA 92108-3754

Phone

(619) 558-6102

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1366136202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 6TH ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823301",
            "telephone_number": "888-682-6282",
            "fax_number": "888-507-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 CAMINO DEL RIO S STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083754",
            "telephone_number": "619-558-6102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W 6th St",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928823301",
            "country_code": "US",
            "telephone_number": "888-682-6282",
            "fax_number": "888-507-7087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GLORIA",
        "middle_name": "MAE",
        "credential": "SUDCC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "11499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Jeanne Graham, DNP
• Edithann Jennings Graham, DMD
• Elizabeth Graham, RBT
• Genesis Graham
• George Henry Graham III, PH.D.
• Heather Lynn Graham, RN
• Katherine Graham, RBT
• Kayla Graham
• Kaylan Arlene Graham, M.D.
• Kelly Graham

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.