Enrique I Gracian, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33183 Issued in CA

Practice address

1127 Wilshire Blvd Ste 1218
Los Angeles, CA 90017-4003

Phone

(213) 712-9595

NPI assigned

Mar 10, 2022

Last updated

Aug 14, 2026By the provider in NPPES

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

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

Specialty

Clinical Psychologist

Education

University of Wisconsin School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Executive Mental Health, Inc.

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1275670036
  Medicare reassignment Care Compare group
• Minder Neuropsychological Services Inc.

  dba Minder Memory Center

  • Psychologist
  • San Diego, CA
  • NPI 1316637200
  Medicare reassignment
• Brian Wu MD PHD Inc

  • Psychiatry Physician
  • San Gabriel, CA
  • NPI 1528639481
  NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1427706241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 1218",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174003",
            "telephone_number": "213-712-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 1218",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174003",
            "telephone_number": "213-712-9595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Boswell Rd Ste 275",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919143557",
            "country_code": "US",
            "telephone_number": "858-279-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACIAN",
        "first_name": "ENRIQUE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracelight Community Health
• Gracelight Community Health
• Mira Shanks Gracer, MD
• Eufemia Gracia
• Janel Gracia, MD
• Jose Gracian
• Cindy C Graciancastro
• Rocio Limon Graciano, LCSW
• Danielle Gradeler, PHARMD
• Carl Anthony Gradford

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.