Individual provider Active NPI

Dianne E Chavez Granillo, COUNSELOR

  • Case Manager/Care Coordinator
  • Los Angeles, CA
National Provider Identifier
1699005728
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6108 Afton PL
Los Angeles, CA 90028-8370
Phone
(323) 461-4118
Fax
(323) 461-4119
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 071636 CA
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

6108 Afton PL
Los Angeles, CA 90028-8370

Mailing address

1911 W 156TH St SPC 50
Compton, CA 90220-3541
Phone (562) 206-6148

Other practice location 1

1911 W 156th St Spc 50
Compton, CA 90220-3541
Phone (562) 206-6148

Other practice location 2

831 E Arrow Hwy
Pomona, CA 91767-2535
Phone (438) 390-9398

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
071636CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1699005728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 W 156TH ST SPC 50",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203541",
            "telephone_number": "562-206-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 AFTON PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900288370",
            "telephone_number": "323-461-4118",
            "fax_number": "323-461-4119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1911 W 156th St Spc 50",
            "address_purpose": "LOCATION",
            "city": "Compton",
            "state": "CA",
            "postal_code": "902203541",
            "country_code": "US",
            "telephone_number": "562-206-6148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 E Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672535",
            "country_code": "US",
            "telephone_number": "438-390-9398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ GRANILLO",
        "first_name": "DIANNE",
        "middle_name": "E",
        "credential": "COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "071636",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.