Provider Demographics
NPI:1669272811
Name:GRAZIANO, JONAH
Entity type:Individual
Prefix:
First Name:JONAH
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 DANA LOOP
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9509
Mailing Address - Country:US
Mailing Address - Phone:916-805-0755
Mailing Address - Fax:
Practice Address - Street 1:2767 DANA LOOP
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9509
Practice Address - Country:US
Practice Address - Phone:916-805-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer