ERIC GRADY (NPI# 1659824399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659824399 |
| Entity Type | Individual |
| Full Name | ERIC GRADY |
| Credential | PH.D |
| Practice Address |
2185 W Grant Line Rd Tracy CA 95377-7309 |
| Practice Telephone | 2098393230 |
| Mailing Telephone | 2098393230 |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY28039 | CA | Behavioral Health & Social Service Providers |
| Street Address |
2185 W GRANT LINE RD |
| City | TRACY |
| State | CA |
| Zip Code | 95377-7309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801870035 | Konrad Boyd Thomas | Obstetrics & Gynecology | 2185 W Grant Line Rd, 2nd Floor, Tracy, CA 95377-7309 | 2005-12-01 |
| 1972013597 | Diane Marie Kennedy | Nurse Practitioner | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-10-10 |
| 1124552419 | Stacy Quach | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1528592748 | Terry K Chow | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1114451564 | Ngoc Son Dang | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-12 |
| 1619409745 | Natalya Pohoryelova | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-03-29 |
| 1235508656 | Nicole Leona Preiss | Psychologist | 2185 W Grant Line Rd, Psychiatry, Tracy, CA 95377-7309 | 2015-09-15 |
| 1477933760 | Jennifer Rae Hulin Segura | Social Worker | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2015-06-02 |
| 1992104715 | Breanne Benedict | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2014-08-18 |
| 1821408519 | Chuanzhong Ye | Psychiatry & Neurology | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2014-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787070 | Mehak Bhardwaj | Behavior Technician | 2434 Saffron Ct, Tracy, CA 95377 | 2020-07-22 |
| 1427510809 | Xiaorui Yang | Behavior Technician | 1951 W Middlefield Dr Apt 224, Tracy, CA 95377 | 2019-04-03 |
| 1962936328 | Duc Nguyen | Pharmacist | 2941 W. Lowell Ave, Apt# 21, Tracy, CA 95377 | 2017-04-12 |
| 1053735043 | Luke Rond | Emergency Medicine | 763 Quail Run Cir, Tracy, CA 95377 | 2014-02-11 |
| 1578862553 | Nhan Duong | Pharmacist | 3250 W. Grant Line Road, Tracy, CA 95377 | 2011-03-16 |
| 1952570582 | Tech Diamond Health Care | Home Health | 2098 Babcock Lane, Tracy, CA 95377 | 2008-02-28 |
| 1316058795 | Wandisan and Rosete Medical Group Professional Corporation | Internal Medicine | 4600 S Tracy Blvd #107, Tracy, CA 95377 | 2006-08-31 |
| 1801838610 | Rollie Duyao Rosete | Internal Medicine | 4600 S Tracy Blvd, #107, Tracy, CA 95377 | 2006-06-13 |
| 1649274663 | Wivina Talabis Urbano | Pediatrics | 4600 South Tracy Blvd, Suite 110, Tracy, CA 95377 | 2005-06-08 |
| 1770586448 | Mitchell Edward Blum | Otolaryngology | 2160 W. Grantline Rd, Suite 250, Tracy, CA 95377 | 2005-05-24 |
| Find all providers in zip 95377 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
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| 1003478405 | Melissa Berrenge-browde | Psychologist | 820 Bay Avenue, Suite 205, Capitola, CA 95010-2102 | 2019-07-05 |
| 1811555840 | Rebecca Cole | Psychologist | 5149 High Meadow Court, Fremont, CA 94536 | 2019-06-04 |
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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.