| Kenneth Graves Jr License Marriage And Family Therapist | |
|
1000 Quail St Ste 135 Newport Beach CA 92660-2719 | |
| (714) 397-2562 | |
| Not Available |
| Full Name | Kenneth Graves Jr License Marriage And Family Therapist |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1000 Quail St Ste 135, Newport Beach, California |
| Authorized Official Name and Position | Kenneth E Graves (OWNER/CFO) |
| Authorized Official Contact | 7143972562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Graves Jr License Marriage And Family Therapist 1000 Quail St Ste 135 Newport Beach CA 92660-2719 Ph: (714) 397-2562 | Kenneth Graves Jr License Marriage And Family Therapist 1000 Quail St Ste 135 Newport Beach CA 92660-2719 Ph: (714) 397-2562 |
| NPI Number | 1437822301 |
|---|---|
| Provider Enumeration Date | 07/27/2021 |
| Last Update Date | 07/27/2021 |
| Certification Date | 07/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437822301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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