Provider Demographics
NPI:1124267638
Name:GRAUBARD, STEVEN H (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:H
Last Name:GRAUBARD
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 1:121 ARLINGTON DR. #5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:617-512-5256
Mailing Address - Fax:617-807-0958
Practice Address - Street 1:595 E. COLORADO BLVD.
Practice Address - Street 2:SUITE 435
Practice Address - City:PSASSDENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:617-512-5256
Practice Address - Fax:617-527-2118
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6934103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist