Juan Angel Graciano, LVN

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

269870 Issued in CA

Practice address

3940 Home Ave
San Diego, CA 92105-5952

Phone

(619) 262-8000

Fax

(619) 266-7405

NPI assigned

May 7, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Juan Angel Graciano Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Diego Treatment Services

  • Methadone Clinic
  • San Diego, CA
  • NPI 1487097960
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1477998136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 COLORADO AVE APT A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919118143",
            "telephone_number": "619-934-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 HOME AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055952",
            "telephone_number": "619-262-8000",
            "fax_number": "619-266-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIANO",
        "first_name": "JUAN",
        "middle_name": "ANGEL",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "269870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "GRACIANO",
            "middle_name": "ANGEL",
            "prefix": "MR.",
            "credential": "LVN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Savannah Nicole Gracey
• Inna Gracheva, FNP
• Jeanette Consuelo Gracia
• Michael Loy Gracia, MD
• Alana Graciano, NP
• Neenah Grade, PA-C
• Sandra Helen Grader, MFT
• Leonel Gradillo Manrique, RDN
• Minerva Grado-Gonzalez
• Grady Family Therapy and Consulting Professional Corporation

• Methadone Clinic in San Diego, CA
• Providers in San Diego, CA by specialty
• Methadone Clinic in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.