| Luis Enrique Graciano, | |
|
21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716-2603 | |
| (562) 754-3997 | |
| Not Available |
| Full Name | Luis Enrique Graciano |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093909319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Enrique Graciano, 15239 Van Ness Ave, Gardena, CA 90249-4147 Ph: (562) 754-3997 | Luis Enrique Graciano, 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716-2603 Ph: (562) 754-3997 |
Mrs. Jessica Foster, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21520 Pioneer Blvd, Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 | |
Yanet R. Gamboa, Couples Therapy Medicare: Medicare Enrolled Practice Location: 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 Fax: 562-246-5704 | |
Jessie Cecilia Ordaz, MA Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 | |
Ms. Renee Camille Rowland, MFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 Fax: 562-865-5244 | |
Yanina V Lambert, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 | |
Ms. Rachel Russell, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 21520 Pioneer Blvd Ste 110, Hawaiian Gardens, CA 90716 Phone: 562-865-3644 Fax: 562-865-3644 |