Provider Demographics
NPI:1356070809
Name:GRAVES, MONIQUE (BSW)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50333
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-0333
Mailing Address - Country:US
Mailing Address - Phone:650-630-0222
Mailing Address - Fax:
Practice Address - Street 1:994 BEECH ST
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-2002
Practice Address - Country:US
Practice Address - Phone:650-630-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker