TELINA MICHELLE GRACE (NPI# 1558912915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558912915 |
| Entity Type | Individual |
| Full Name | TELINA MICHELLE GRACE |
| Practice Address |
14240 Imperial Hwy La Mirada CA 90638-1940 |
| Practice Telephone | 5629461587 |
| Practice Fax Number | 5629465740 |
| Mailing Telephone | 5629461587 |
| Mailing Fax Number | 5629465740 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
105202 | CA | Behavioral Health & Social Service Providers |
| Street Address |
14240 IMPERIAL HWY |
| City | LA MIRADA |
| State | CA |
| Zip Code | 90638-1940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982754479 | Louie Martin Gunderson | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2007-01-10 |
| 1639725328 | Romelia Marttini | Licensed Vocational Nurse | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2019-08-18 |
| 1679125736 | Mariana Cordova | Licensed Vocational Nurse | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2019-07-09 |
| 1619470713 | Reginald Kent Anderson | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2018-03-14 |
| 1730694522 | Ninoska Velo | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638 | 2017-12-04 |
| 1598216400 | Martha Nayely Rodriguez | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-10-17 |
| 1942756226 | Aidan Guerrero | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-08-28 |
| 1699135343 | Mayela Lopez | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-02-23 |
| 1770940181 | Kris Michelle Hendry | Behavioral Analyst | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-01-15 |
| 1932545779 | Aegis Treatment Centers, LLC | Clinic/Center | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2013-05-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972144095 | Amanda Connell | Counselor | 13710 La Mirada Blvd., Straight Talk, La Mirada, CA 90638 | 2019-09-30 |
| 1679054894 | James Kim | Occupational Therapist | 11926 La Mirada Blvd., La Mirada, CA 90638 | 2018-08-25 |
| 1780163915 | Complete Spine and Joint Center Inc | Chiropractor | 15112 Rosecrans Ave, La Mirada, CA 90638 | 2018-08-08 |
| 1124520606 | Meredith Narcisse | Counselor | Aegis Treatment Center 14240 Imperial Hwy, La Mirida, CA 90638 | 2018-03-01 |
| 1336685114 | Dorina Hamilton | Counselor | 14240 E. Imperial Hwy., La Mirada, CA 90638 | 2017-01-17 |
| 1497201768 | Blm Pharmacy Inc | Pharmacy | 12675 La Mirada Blvd., Suite 100, La Mirada, CA 90638 | 2016-08-28 |
| 1972954535 | Wendy Tran | Dentist | 12265 La Mirada Blvd, La Mirada, CA 90638 | 2016-06-24 |
| 1962851410 | Amy Bender | Counselor | 14240 Imperial Highway, La Mirada, CA 90638 | 2016-06-06 |
| 1699137430 | Andrea Lauren Smith | Chiropractor | 15651 East Imperial Hwy Ste 100, La Mirada, CA 90638 | 2016-03-22 |
| 1750797098 | Napoleon Tiquia | General Practice | 12049 Hartdale Avenue, La Mirada, CA 90638 | 2014-07-08 |
| Find all providers in zip 90638 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245796184 | Steve Leonardo Thompson | Counselor | 14645 Los Fuentes Rd, La Mirada, CA 90638-4355 | 2019-02-15 |
| 1336685114 | Dorina Hamilton | Counselor | 14240 E. Imperial Hwy., La Mirada, CA 90638 | 2017-01-17 |
| 1962851410 | Amy Bender | Counselor | 14240 Imperial Highway, La Mirada, CA 90638 | 2016-06-06 |
| 1871786038 | Lesvy Jackeline Granillo | Counselor | 14240 East Imperial Hwy, La Mirada, CA 90638-8123 | 2007-08-21 |
| 1245376144 | Michael Rosa | Counselor | 14240 East Imperial Highway, La Mirada, CA 90638 | 2007-01-29 |
| 1982754479 | Louie Martin Gunderson | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2007-01-10 |
| 1619470713 | Reginald Kent Anderson | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2018-03-14 |
| 1730694522 | Ninoska Velo | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638 | 2017-12-04 |
| 1598216400 | Martha Nayely Rodriguez | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-10-17 |
| 1942756226 | Aidan Guerrero | Counselor | 14240 Imperial Hwy, La Mirada, CA 90638-1940 | 2016-08-28 |
| Find all providers in LA MIRADA | ||||
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| 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.