Basic Information
| Provider Information | |||||||||
| NPI: | 1124267638 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRAUBARD | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 ARLINGTON DR. #5 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175125256 | ||||||||
| FaxNumber: | 6178070958 | ||||||||
| Practice Location | |||||||||
| Address1: | 595 E. COLORADO BLVD. | ||||||||
| Address2: | SUITE 435 | ||||||||
| City: | PSASSDENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175125256 | ||||||||
| FaxNumber: | 6175272118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2009 | ||||||||
| LastUpdateDate: | 09/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 6934 | MA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.