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General NPI Number Information
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NPI Number | 1497236673
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Entity Type | Individual
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Provider Name | MERI TUULI GRAHAM
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Gender | Female
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 10/05/2024
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Provider Practice Location Address
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Address Line | 5201 GREAT AMERICA PKWY STE 320
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City | SANTA CLARA
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State | CA
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Zip | 95054-1140
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Country | US
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Telephone | 510-317-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 246 E 16TH ST # A
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City | COSTA MESA
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State | CA
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Zip | 92627-3804
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Country | US
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Telephone | 949-375-9692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW124841
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License Number State | CA
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