Active NPI
Grace Michelle Khoury, M.D.
- Psychiatry Physician
- Riverside, CA
National Provider Identifier
1417534710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A202942
- Practice address
- 9990 County Farm Rd
Riverside, CA 92503-3542 - Phone
- (951) 486-4000
- NPI assigned
- Mar 24, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A202942 | CA | Primary |
Addresses
Primary practice location
9990 County Farm Rd
Riverside, CA 92503-3542
Mailing address
9990 County Farm Rd
Riverside, CA 92503-3542
Phone (951) 486-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210719001487 | VA | Order and Referring Only - Psychiatry | 8224431911 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A202942 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1417534710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9990 COUNTY FARM RD",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033542",
"telephone_number": "951-486-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9990 COUNTY FARM RD",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033542",
"telephone_number": "951-486-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOURY",
"first_name": "GRACE",
"middle_name": "MICHELLE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-24",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A202942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.