Individual
DR. CAROLYN NAN GRACIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
810 COLLEGE AVE, SUITE 9, KENTFIELD, CA 94904-2532
(415) 459-4311
Mailing address
810 COLLEGE AVE, SUITE 9, KENTFIELD, CA 94904-2532
(415) 459-4311
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A33033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A33033
LICENSE NUMBER
CA
Enumeration date
09/26/2006
Last updated
07/08/2007
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