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General NPI Number Information
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NPI Number | 1851907430
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Entity Type | Individual
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Provider Name | ADRIENNE GRASHAW
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Gender | Female
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Dates
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Enumeration Date | 09/19/2020
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Last Update Date | 09/19/2020
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Provider Practice Location Address
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Address Line | 2644 30TH ST STE 100
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City | SANTA MONICA
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State | CA
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Zip | 90405-3051
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Country | US
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Telephone | 310-314-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 2644 30TH ST STE 100
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City | SANTA MONICA
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State | CA
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Zip | 90405-3051
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Country | US
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Telephone | 310-314-6200
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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