Address: 4261 San Pedro Pl, Los Angeles, CA 90011-2917

SHONTAE L GRAHAM (NPI# 1780177428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780177428
Entity Type Individual
Gender Female
Credential CC, MSP
Practice Address 4261 San Pedro Pl
Los Angeles
CA 90011-2917
Practice Telephone 3107706749
Mailing Address 4261 San Pedro Pl # 409
Los Angeles
CA 90011-2917
Mailing Telephone 3107706749
Enumeration Date 2018-06-07
Last Update Date 2018-06-07
Is Sole Proprietor N


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 101Y00000X Counselor CA Behavioral Health & Social Service Providers

Other Provider Identifiers

Identifier State Issuer Type Code

Office Location

Street Address 4261 SAN PEDRO PL
State CA
Zip Code 90011-2917

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1821222811 Ismael Francisco Driver 531 E 36th St, Suite 1, Los Angeles, CA 90011 2009-05-06
1033533153 Avalon-Carver Community Center Community/Behavioral Health 4920 S. Avalon Blvd, Los Angeles, CA 90011 2014-02-10
1063884633 Wing Sze Tina Ip · Wing Sze Tina Pearson Pharmacist 4211 South Avalon Blvd, Los Angeles, CA 90011 2015-10-22
1205252533 Jameese B Smith Case Manager/Care Coordinator 271 E. 43rd Street, Los Angeles, CA 90011 2014-03-11
1164941183 Kimberly Denise Lister- Gutierrez Counselor 303 E 52nd Street, Los Angeles, CA 90011 2017-09-11
1093308009 South Central Family Health Center Clinic/Center - Federally Qualified Health Center (FQHC) 4411 S Central Ave, Los Angeles, CA 90011 2021-02-19
1285993451 Benjamin Tehrani · Benjamin Tehrani Podiatrist - Foot & Ankle Surgery 2514 S. Central Avenue, Los Angeles, CA 90011 2012-05-09
1326362609 Daniel Ochoa Counselor - Addiction (Substance Use Disorder) 2116 S. Central Ave, Los Angeles, CA 90011 2010-03-16
1073863445 Ronald Armado Pharmacist 4211 S. Avalon, Los Angeles, CA 90011 2012-09-13
1912343344 California Assisted Pharmacy, Inc · California Assisted Pharmacy Pharmacy 646 E 28th St, Ste #1, Los Angeles, CA 90011 2013-05-13
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1992380083 Farhang Holakouee Counselor 11845 W Olympic Blvd # 820, Los Angeles, CA 90064-1149 2021-03-10
1194315663 Rita Burgos Counselor 454 N Avenue 56 # 1, Los Angeles, CA 90042-3335 2021-01-19
1215533138 Natalie Andrea Donis Counselor 1042 W 94th St Apt 1/4, Los Angeles, CA 90044-3269 2020-12-07
1952913055 Jose Islas Counselor 4396 1/2 Lovett St, Los Angeles, CA 90023-4117 2020-08-19
1154931491 Delia Maria Cortez Counselor 12133 Clarkson Rd, Los Angeles, CA 90064-3519 2020-08-02
1457974263 Simeon Simov Counselor 11845 W Olympic Blvd # 815e, Los Angeles, CA 90064-1149 2020-05-27
1780206524 Keisha Whitfield Counselor 1123 W 7th St # 25, Los Angeles, CA 90017-2409 2020-05-14
1467073965 Flowlab Inc Counselor 4528 Los Feliz Blvd, Los Angeles, CA 90027-2006 2020-05-06
1366061624 Elysian Psychology Inc Counselor 10250 Constellation Blvd, Los Angeles, CA 90067-6200 2020-04-15
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Zip Code 90011

Providers with similar names

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1205428513 Trista T Graham Community Health Worker 1282 Sewell St S, Rainelle, WV 25962-7140 2021-02-08
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1619556529 Regina Graham Social Worker 950 S Jan Dr, Panama City, FL 32404-9628 2021-04-07
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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.