Raphael E Graham Sr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1588251124 Issued in CA

Practice address

762 Griswold Ave
San Fernando, CA 91340-2105

Phone

(747) 500-9405

NPI assigned

May 22, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Fernando Recovery Center

  • Substance Abuse Rehabilitation Facility
  • San Fernando, CA
  • NPI 1164980603
  NPD (past)
• San Fernando Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Fernando, CA
  • NPI 1275478745
  NPD (past)

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1992598015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13187 BROMONT AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424310",
            "telephone_number": "818-356-1088",
            "fax_number": "818-356-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 GRISWOLD AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402105",
            "telephone_number": "747-500-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "RAPHAEL",
        "middle_name": "E",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1588251124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Gonzalez
• Nancy Gonzalez
• Yailin Gonzalez
• Viki Goodman, LMFT
• Larisa Gorelik, PHARMACIST
• Stephanie Regena Green, MD
• Tiona Green
• Joan Lee-Shu Grosman, MD
• Dolores Bonnie Guerrero-Reynaldo, LVN
• Alma Delia Guerrero, M.D.

• Addiction (Substance Use Disorder) Counselor in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.