Jennifer Graves

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009046 Issued in CA

Practice address

220 S Palisade Dr Ste 203
Santa Maria, CA 93454

Phone

(805) 354-7101

Fax

(805) 354-7102

NPI assigned

Nov 7, 2017

Last updated

Mar 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1639682057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. CHURCH STREET",
            "address_2": "ATTENTION: MEDICAL STAFF OFFICE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S PALISADE DR STE 203",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-354-7101",
            "fax_number": "805-354-7102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Santa Rosa St Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93405",
            "country_code": "US",
            "telephone_number": "805-782-8132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009046",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60468129",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "722652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takana Ariela Gottschalk, QMHW
• Noureen Gowani
• Ada Grace, RN
• Jonathan Ivan Granados
• Gratitude Behavioral Health Inc Licensed Clinical Social Worker
• Britney Grayson, PT, DPT
• Joshua Robert Greco, PH.D.
• Mary Elizabeth Greco, CCC/SLP
• Pauline Alicia Green
• Sarah Catherine Green, P.A.

• Family Nurse Practitioner in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.