Healthcare Provider Details

I. General information

NPI: 1225922792
Provider Name (Legal Business Name): GRAIES PSYCHOLOGICAL SERVICES, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W CALIFORNIA BLVD STE 221
PASADENA CA
91105-3032
US

IV. Provider business mailing address

1009 N PACIFIC AVE UNIT 4065
GLENDALE CA
91202-2313
US

V. Phone/Fax

Practice location:
  • Phone: 818-272-8753
  • Fax: 747-271-5968
Mailing address:
  • Phone: 818-272-8753
  • Fax: 747-271-5968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: NANCY GRAIES
Title or Position: CEO/LICENSED PSYCHOLOGIST
Credential: PSYD
Phone: 818-272-8753