Marvin Darnell Graddy, is a
Psychologist - Addiction (substance Use Disorder) based in Antioch, California. Marvin Darnell Graddy is licensed to practice in California (license number 101YA0400X) and his current practice location is
1320 Rockspring Way, Antioch, California. He can be reached at his office (for appointments etc.) via phone at
(925) 334-9906.
NPI number for Marvin Darnell Graddy is 1144805011 and his current mailing address is 3707 Sunset Ln, Antioch, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144805011.
Healthcare Provider's Profile
| Full Name | Marvin Darnell Graddy |
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| Gender | Male |
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| Speciality | Psychologist - Addiction (substance Use Disorder) |
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| Location | 1320 Rockspring Way, Antioch, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1144805011
- Provider Enumeration Date: 03/12/2021
- Last Update Date: 03/12/2021
Medical Identifiers
Medical identifiers for Marvin Darnell Graddy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144805011 | NPI | - | NPPES |
| 5VE8-FC6-UP53 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 101YA0400X (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | 101YA0400X (California) | Secondary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 101YA0400X (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marvin Darnell Graddy is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Marvin Darnell Graddy,
3707 Sunset Ln,
Antioch, CA 94509-6101
Ph: (925) 522-0124 | Marvin Darnell Graddy,
1320 Rockspring Way,
Antioch, CA 94531-8397
Ph: (925) 334-9906 |
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