Provider Demographics
NPI:1801014899
Name:GRAFF, STEVEN MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARTIN
Last Name:GRAFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-4430
Mailing Address - Country:US
Mailing Address - Phone:805-484-5124
Mailing Address - Fax:
Practice Address - Street 1:2401 E GONZALES RD
Practice Address - Street 2:SUITE 100 TCRC
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0652
Practice Address - Country:US
Practice Address - Phone:805-351-3113
Practice Address - Fax:805-278-9056
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11433103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY114330Medicaid
CACP11433Medicare PIN