Adrienne Laura McGrael-Souders, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

295111 Issued in CA

Practice address

500 San Pablo Ave Ste 300
Albany, CA 94706-1103

Phone

(510) 204-8130

Fax

(510) 524-0861

NPI assigned

Jun 22, 2005

Reactivated

Mar 30, 2006

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: amcgraelsouders45753@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1740286079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE STE 300",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAEL-SOUDERS",
        "first_name": "ADRIENNE",
        "middle_name": "LAURA",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-10-03",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "295111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "G48839",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hossein M Massoudi, MPT
• Linda Ann Mayo, D.C.
• Gena McCarthy, MFT
• Katherine McCarthy, L. AC.
• Elizabeth Anne McCoy
• Mali Mackenzie Kasumi McGuire, DDS
• Dana Kathleen McMullen, LMFT
• Angela Sue Meade, DPT
• Kirsten Meadows, MFT
• Medisa Payvarpour Psychological Services Inc

• Family Medicine Physician in Albany, CA
• Providers in Albany, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.