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NPI Code Detail

MEDICARE: ANTOINE JOSEPH GRACE

MEDICARE: ANTOINE JOSEPH GRACE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1275960098
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINE JOSEPH GRACE
Provider Business Mailing Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number : 213-621-4155
Provider Business Practice Location Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number : 213-621-4155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2013
Last Update Date : 02/22/2026

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Directions to “ ANTOINE JOSEPH GRACE ” Practice Location

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