Active NPI
Monique D'Lisa Gray
- Massage Therapist
- Culver City, CA
National Provider Identifier
1821374620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 82712
- Practice address
- 6666 Green Valley Cir
Culver City, CA 90230-7068 - Phone
- (310) 846-5270
- Fax
- (310) 846-5278
- NPI assigned
- Oct 25, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Massage Therapist | 225700000X | |||
| Massage Therapist | 225700000X | 82712 | CA | Primary |
Addresses
Primary practice location
6666 Green Valley Cir
Culver City, CA 90230-7068
Mailing address
6666 Green Valley Cir
Culver City, CA 90230-7068
Phone (310) 846-5270
Other practice location 1
901 Dover Dr
Newport Beach, CA 92660-5538
Phone (949) 500-8563
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 |
|---|---|---|---|
| 82712 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1821374620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6666 GREEN VALLEY CIR",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902307068",
"telephone_number": "310-846-5270",
"fax_number": "310-846-5278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6666 GREEN VALLEY CIR",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902307068",
"telephone_number": "310-846-5270",
"fax_number": "310-846-5278"
}
],
"practiceLocations": [
{
"address_1": "901 Dover Dr",
"address_purpose": "LOCATION",
"city": "Newport Beach",
"state": "CA",
"postal_code": "926605538",
"country_code": "US",
"telephone_number": "949-500-8563",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRAY",
"first_name": "MONIQUE",
"middle_name": "D'LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-25",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "82712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.