GRACIELA PEREZ PONCE (NPI# 1417437831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417437831 |
| Entity Type | Individual |
| Full Name | GRACIELA PEREZ PONCE |
| Practice Address |
3820 Martin Luther King Jr Blvd Lynwood CA 90262-3625 |
| Mailing Address |
1567 E 22nd St Los Angeles CA 90011-1350 |
| Practice Telephone | 3106320421 |
| Mailing Telephone | 3238364566 |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225800000X | Recreation Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3820 MARTIN LUTHER KING JR BLVD |
| City | LYNWOOD |
| State | CA |
| Zip Code | 90262-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417798 | Lisa A Brockman | Internal Medicine | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2005-06-17 |
| 1275132839 | Claire Anne Vasquez | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-10-23 |
| 1295347276 | Beatriz Borjas | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-08-20 |
| 1629696422 | Jacqueline Lara | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-07-08 |
| 1457977530 | Elise Boretz | Dietitian, Registered | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-06-24 |
| 1538784806 | Rosa Lemus | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-06-12 |
| 1861021206 | Brenda Martin | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-04-07 |
| 1578197802 | Jorge Serrano | Licensed Vocational Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-02-25 |
| 1356988414 | Belen Gonzalez | Licensed Vocational Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2019-12-06 |
| 1659917912 | Carla Solis | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2019-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546062 | Sheila Maxine Wilkins | Technician | 3940 Palm Ave, Lynwood, CA 90262 | 2019-09-10 |
| 1891344669 | Chezoma Latissue Davis | Technician | 4255 Niland St, Lynwood, CA 90262 | 2019-09-05 |
| 1295223345 | Scla Comprehensive Surgical Medical Group, Inc. | Clinic/Center | 3628 E Imperial Hwy Ste 204, Lynwood, CA 90262 | 2018-04-24 |
| 1891213807 | Grecia Veronica Nunez | Case Manager/Care Coordinator | 3680 E. Imperial Highway, Suite 200, Lynwood, CA 90262 | 2017-08-30 |
| 1134643448 | Angelica Jazmin Alonso Cortes | Case Manager/Care Coordinator | 2610 Industry Way Suite A, Lynwood, CA 90262 | 2017-07-28 |
| 1134594997 | Corinne Palma | Counselor | 11705 S. Alameda St., Lynwood, CA 90262 | 2015-12-04 |
| 1891175550 | Nancy Bremmer | Counselor | 10705 S. Alameda Street, Los Angels, CA 90262 | 2015-06-08 |
| 1588041347 | Jennifer Montoya | Case Management | 5433 E. Pelleur St., Lynwood, CA 90262 | 2015-04-30 |
| 1124440060 | Susana Gyek Goy | Chiropractor | 11123 Long Beach Blvd. Suite 5, Lynwood Health Center, Lynwood, CA 90262 | 2014-01-13 |
| 1215368956 | Baart Community Healthcare | Clinic/Center | 11315 S. Atlantic Blvd., Lynwood, CA 90262 | 2013-12-05 |
| Find all providers in zip 90262 | ||||
| Taxonomy Code | 225800000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Recreation Therapist |
| A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
| Notes: Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733233 | Kevin Mccann | Recreation Therapist | 201 9th St # 11-k, Marina, CA 93933-6039 | 2020-06-03 |
| 1962024950 | Jacqueline K Volz | Recreation Therapist | 21732 S Vermont Ave, Torrance, CA 90502-2179 | 2020-05-12 |
| 1578190104 | Carolyn Neufeld | Recreation Therapist | 2915 Buthmann Ave, Tracy, CA 95376-1806 | 2020-03-24 |
| 1922634625 | Deborah Paulus | Recreation Therapist | 4777 Grouse Run Dr Apt 218, Stockton, CA 95207-5384 | 2020-03-14 |
| 1518433259 | Jenality Thurman | Recreation Therapist | 1766 Kenneth St, Seaside, CA 93955-3842 | 2018-10-20 |
| 1962986042 | Long Pham | Recreation Therapist | 7175 Enclave Dr, Eastvale, CA 92880-3828 | 2018-09-24 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1669995742 | Christina Randle | Recreation Therapist | 2221 Lily Ave, Upland, CA 91784-7997 | 2017-07-20 |
| 1982127288 | Tiffany Chiyeko Yonemoto | Recreation Therapist | 7601 E. Imperial Hwy., Downey, CA 90242 | 2017-07-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.