Provider Demographics
NPI:1790108959
Name:GRALIAN, MONICA LEE
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LEE
Last Name:GRALIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 PLACER ST
Mailing Address - Street 2:STE. 207
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 SOUTH ST STE F
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2101
Practice Address - Country:US
Practice Address - Phone:530-941-1017
Practice Address - Fax:530-241-1095
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant