Healthcare Provider Details

I. General information

NPI: 1285560284
Provider Name (Legal Business Name): PAULA GRAYSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 E 49TH ST
LOS ANGELES CA
90011-4203
US

IV. Provider business mailing address

PO BOX 603093
CLEVELAND OH
44103-0093
US

V. Phone/Fax

Practice location:
  • Phone: 216-358-9638
  • Fax:
Mailing address:
  • Phone: 216-358-9638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCHW.002052
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: