Individual provider Active NPI

Myila Nicole Granberry, M.ED

  • Case Manager/Care Coordinator
  • Oakland, CA
National Provider Identifier
1962668053
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
8945 Golf Links Rd
Oakland, CA 94605-4124
Phone
(510) 317-1444
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

8945 Golf Links Rd
Oakland, CA 94605-4124

Mailing address

8945 Golf Links Rd
Oakland, CA 94605-4124
Phone (510) 317-1444

Other identifiers 1

IdentifierTypeStateIssuer
171M00000XMedicaidCA

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
Credentials
Master of Education

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1962668053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8945 GOLF LINKS RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054124",
            "telephone_number": "510-317-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8945 GOLF LINKS RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054124",
            "telephone_number": "510-317-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERRY",
        "first_name": "MYILA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.

Verify at the official NPI Registry.