Carolyn Nan Gracie, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A33033 Issued in CA

Practice address

810 College Ave
Suite 9
Kentfield, CA 94904-2532

Phone

(415) 459-4311

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2013 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639260862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 COLLEGE AVE",
            "address_2": "SUITE 9",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949042532",
            "telephone_number": "415-459-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 COLLEGE AVE",
            "address_2": "SUITE 9",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949042532",
            "telephone_number": "415-459-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIE",
        "first_name": "CAROLYN",
        "middle_name": "NAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A33033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A33033",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Goldyne, MFT
• Julia Gombos
• April Azucena Gonzalez, PA-C
• Irwin Gootnick, M.D.
• Susan A. Gootnick, M.D.
• Victoria C. Granucci, PH.D.
• Elizabeth P Greason, L.C.S.W.
• Julianne Guida
• Diamond Hardman
• Nancy Hughes Haugen, PH.D.

• Psychiatry Physician in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Psychiatry Physician in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.