Healthcare Provider Details

I. General information

NPI: 1295232551
Provider Name (Legal Business Name): ADRIANA ELENA GRAMSAS DNP, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDI ELENA GRAMSAS DNP, AGNP-C

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S FAIR OAKS AVE STE 215
PASADENA CA
91105-2613
US

IV. Provider business mailing address

625 S FAIR OAKS AVE # 215
PASADENA CA
91105-2613
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-4139
  • Fax: 626-584-0016
Mailing address:
  • Phone: 626-793-4139
  • Fax: 626-584-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95040554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: