Active NPI
Domonique Grigsby
- Social Worker
- Los Angeles, CA
National Provider Identifier
1740064526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1811 W 41St Dr
Los Angeles, CA 90062-1517 - Phone
- (323) 348-4615
- NPI assigned
- Aug 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1811 W 41St Dr
Los Angeles, CA 90062-1517
Mailing address
1811 W 41St Dr
Los Angeles, CA 90062-1517
Phone (323) 348-4615
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Growth Foundation | Current | Accepting new patients |
Organizations & group practices 1
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.
-
dba Mindful Growth Foundation #2
- Mental Illness Community Based Residential Treatment Facility
- Los Angeles, CA
- NPI 1952989923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1740064526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 W 41ST DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621517",
"telephone_number": "323-348-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 W 41ST DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621517",
"telephone_number": "323-348-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGSBY",
"first_name": "DOMONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"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 Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.