Individual provider Active NPI

Grace Lally

  • Registered Nurse
  • Seal Beach, CA
National Provider Identifier
1487494654
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
802855 Issued in CA
Practice address
12400 Montecito Rd Apt 401
Seal Beach, CA 90740-2736
Phone
(562) 480-3119
NPI assigned
May 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 802855 CA
Community Health Registered Nurse 163WC1500X 802855 CA
Lactation Consultant (Registered Nurse) 163WL0100X 802855 CA
Maternal Newborn Registered Nurse 163WM0102X 802855 CA
Low-Risk Neonatal Registered Nurse 163WN0003X 802855 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 802855 CA
Perinatal Registered Nurse 163WP1700X 802855 CA
High-Risk Obstetric Registered Nurse 163WX0002X 802855 CA
Registered Nurse 163W00000X 802855 CA Primary

Addresses

Primary practice location

12400 Montecito Rd Apt 401
Seal Beach, CA 90740-2736

Mailing address

12400 Montecito Rd Apt 401
Seal Beach, CA 90740-2736
Phone (562) 480-3119

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

State licenses

LicenseStateTypeSpecialty
802855CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1487494654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 MONTECITO RD APT 401",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402736",
            "telephone_number": "562-480-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 MONTECITO RD APT 401",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402736",
            "telephone_number": "562-480-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLY",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163WX0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, High-Risk",
            "state": "CA",
            "license": "802855",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "802855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; 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.