Selena Marie Granados, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY33248 Issued in CA

Practice address

1050 Lakes Dr Ste 225
West Covina, CA 91790-2910

Phone

(626) 373-8384

NPI assigned

May 25, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Coast Children'S Society, Inc.

  • Community/Behavioral Health Agency
  • Rancho Cucamonga, CA
  • NPI 1962848127
  NPD (past)

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

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1730314428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1776",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917220776",
            "telephone_number": "619-318-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LAKES DR STE 225",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902910",
            "telephone_number": "626-373-8384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25910 Acero Ste 160",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926912777",
            "country_code": "US",
            "telephone_number": "909-367-0746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "SELENA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-25",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracious Home Health Care LLC
• Staci Janae Graham
• David Granados
• Jeffrey-Jonathan Ocfemia Granados, O.D.
• Melissa Granados
• Grandcare Medical LLC
• Beth Anne Grant, LCSW
• Greater Valley Pharmacy
• Lianna Louise Greer, ATC
• Gregory L. Gorski, a Professional Medical Corp

• Psychologist in West Covina, CA
• Providers in West Covina, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.