Individual provider Active NPI

Brooke Janay Grandison

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1407511587
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118207 Issued in CA
Practice address
600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148
Phone
(909) 522-4656
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 118207 CA Primary

Addresses

Primary practice location

600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148

Mailing address

1210 Janes Way
Colton, CA 92324-1669
Phone (760) 671-0091

Other practice location 1

1210 Janes Way
Colton, CA 92324-1669
Phone (951) 990-0329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201000559 CA Practitioner - Clinical Social Worker 3072961051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1210 Janes Way
Colton, CA 92324-1669
Phone (760) 671-0091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Essentials for Healing Inc. Clinical CurrentSince Oct 7, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1407511587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 JANES WAY",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241669",
            "telephone_number": "760-671-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ARROWHEAD AVE STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011148",
            "telephone_number": "909-522-4656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 Janes Way",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241669",
            "country_code": "US",
            "telephone_number": "951-990-0329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANDISON",
        "first_name": "BROOKE",
        "middle_name": "JANAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "118207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.