Individual provider Active NPI

McHeko Graves-Matthews, M.D.

  • Forensic Psychiatry Physician
  • San Leandro, CA
National Provider Identifier
1588866735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
G60542 Issued in CA
Practice address
2055 Fairmont Drive
San Leandro, CA 94578
Phone
(510) 667-3950
Fax
(510) 667-3903
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X G60542 CA Primary

Addresses

Primary practice location

2055 Fairmont Drive
San Leandro, CA 94578

Mailing address

2055 Fairmont Drive
San Leandro, CA 94578
Phone (510) 667-3950

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60542CAMDForensic Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588866735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 FAIRMONT DRIVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-667-3950",
            "fax_number": "510-667-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 FAIRMONT DRIVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-667-3950",
            "fax_number": "510-667-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES-MATTHEWS",
        "first_name": "MCHEKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "G60542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.