MEDICARE: GRAIES PSYCHOLOGICAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1225922792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAIES PSYCHOLOGICAL SERVICES INC

Provider Business Mailing Address
First Line	:	1009 N PACIFIC AVE UNIT 4065
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2313
Country	:	US
Telephone Number	:	800-455-7013
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 E COLORADO ST STE 200
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1298
Country	:	US
Telephone Number	:	800-455-7013
Fax Number	:

Authorized Official
Title or Position	:	CEO/LICENSED PSYCHOLOGIST
Name	:	NANCY GRAIES
Credential	:	PSYD
Telephone Number	:	323-628-2650

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	11/21/2025

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