Provider Demographics
NPI:1801024609
Name:STRATTON, GRAYCE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAYCE
Middle Name:MARIE
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 BLACK AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6144
Mailing Address - Country:US
Mailing Address - Phone:925-462-2123
Mailing Address - Fax:925-462-2123
Practice Address - Street 1:4450 BLACK AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6144
Practice Address - Country:US
Practice Address - Phone:925-462-2123
Practice Address - Fax:925-462-2123
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21668103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical