Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
SHONTAE L GRAHAM
Active
Individual
SHONTAE L GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CC, MSP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17773901
LA COUNTY VENDOR ID NUMBER
CA
Enumeration date
06/07/2018
Last updated
06/07/2018
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