Grace O Adeagbo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95005218 Issued in CA

Practice address

2204 Torrance Blvd Ste 102
Torrance, CA 90501-0502

Phone

(424) 488-2030

Fax

(424) 488-2202

NPI assigned

Nov 20, 2007

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Mehboob Makhani MD a Professional CorporationGroup PAC ID 9133387442, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mehboob Makhani MD a Professional Corporation

  • Psychiatry Physician
  • Northridge, CA
  • NPI 1578835724
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1649217761

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Easy Access Medical Supply, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Downey, CA
  • NPI 1285855619
  NPD (past) Authorized official
• Global Grace Medical Services Inc

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1306495908
  Authorized official Same address or phone
• Global Mobile Medical Alliances, Inc.

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1467960310
  NPD
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1336977990

  Psychiatric/Mental Health

  NPD
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Lake Forest, CA
  • NPI 1346774445
  NPD
• 1 Community Wellness & Health Inc

  • Family Medicine Physician
  • Baldwin Park, CA
  • NPI 1417184599
  NPD (past)
• California Mobile Medical Group Inc

  dba The Mobile DRS

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1588439061
  NPD (past)
• Mobile Physicians Medical Allied Group Inc

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1184199275
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1992986731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 ADOREE ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902424900",
            "telephone_number": "562-803-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 TORRANCE BLVD STE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905010502",
            "telephone_number": "424-488-2030",
            "fax_number": "424-488-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEAGBO",
        "first_name": "GRACE",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005218",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95005218",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "635727",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "635727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammie Lajuana Adams, DMD
• Tyonna Adams
• Rukky Adanike
• Irina Addes
• Addis Medical Group a Medical Corporation
• Asiata Oyinlade Adekunle, ACSW
• Zainab M Aderounmu
• Chelsea Ades, DPT
• Adf Investments LLC (Huntington Retirement Hotel)
• Omid Adibnazari, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Torrance, CA
• Providers in Torrance, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.