Gavin Graham

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1474440722 Issued in CA

Practice address

18700 Oxnard St
Tarzana, CA 91356-1413

Phone

(310) 699-7133

NPI assigned

Jul 12, 2022

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1396479689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 23RD ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 OXNARD ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561413",
            "telephone_number": "310-699-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GAVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1474440722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Gouyoumjian, QASP-S
• Corrie Leanne Gradney, RADT
• Rania Graetz, AMFT
• Graham Mouw, M.D., a Medical Corporation
• Deborah Ann Graham
• Michael Glenn Graham
• Ahou Marcelle Gray
• Alissa Madeline Gray, MA, AMFT, APCC
• Esperanza G Gray
• Garin Gray

• Addiction (Substance Use Disorder) Counselor in Tarzana, CA
• Providers in Tarzana, 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 Jul 12, 2022; 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.