1801014899 NPI number — DR. STEVEN MARTIN GRAFF PH.D.

Table of content: DR. STEVEN MARTIN GRAFF PH.D. (NPI 1801014899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801014899 NPI number — DR. STEVEN MARTIN GRAFF PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAFF
Provider First Name:
STEVEN
Provider Middle Name:
MARTIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801014899
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 FRAZIER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMARILLO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93012-4430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-484-5124
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 E GONZALES RD
Provider Second Line Business Practice Location Address:
SUITE 100 TCRC
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93036-0652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-351-3113
Provider Business Practice Location Address Fax Number:
805-278-9056
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TM1800X , with the licence number:  PSY11433 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PSY114330 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com