Active NPI
Nicki Nakessa Griswold
- Addiction (Substance Use Disorder) Counselor
- La Puente, CA
National Provider Identifier
1760519862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- G0409281511
- Practice address
- 15229 Amar Rd
La Puente, CA 91744-2066 - Phone
- (626) 855-5090
- Fax
- (626) 961-1810
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | G0409281511 | CA | Primary |
Addresses
Primary practice location
15229 Amar Rd
La Puente, CA 91744-2066
Mailing address
2399 White St
Pasadena, CA 91107-3265
Phone (626) 796-8747
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
| License | State | Type | Specialty |
|---|---|---|---|
| G0409281511 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760519862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2399 WHITE ST",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073265",
"telephone_number": "626-796-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15229 AMAR RD",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917442066",
"telephone_number": "626-855-5090",
"fax_number": "626-961-1810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISWOLD",
"first_name": "NICKI",
"middle_name": "NAKESSA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "G0409281511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.