Active NPI
Sean Michael McGraw
- Emotionally Disturbed Childrens' Residential Treatment Facility
- San Rafael, CA
National Provider Identifier
1417234972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Practice address
- 1 Saint Vincents Dr
San Rafael, CA 94903-1504 - Phone
- (415) 507-4232
- NPI assigned
- Nov 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | Primary |
Addresses
Primary practice location
1 Saint Vincents Dr
San Rafael, CA 94903-1504
Mailing address
1 Saint Vincents Dr
San Rafael, CA 94903-1504
Phone (415) 507-4232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321056000000",
"number": "1417234972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SAINT VINCENTS DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031504",
"telephone_number": "415-507-4232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SAINT VINCENTS DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031504",
"telephone_number": "415-507-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGRAW",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-12",
"last_updated": "2011-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.