Kiesha Graves
Counselor, Professional in San Dimas, CA. Individual provider (NPI-1).
NPI number1356904841
StatusActive
Last updated in NPPESApr 19, 2019
Details
- NPI
- 1356904841
- Entity type
- Individual (NPI-1)
- Name
- Kiesha Graves
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2019
- Last updated
- Apr 19, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 3375 | CA | Yes |
Practice location
762 Cypress StSan Dimas, CA 91773-3505
Phone 909-599-1227
Mailing address
762 Cypress StSan Dimas, CA 91773-3505
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Professional Counselor providers in San Dimas · All 1,245 providers in San Dimas
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