Provider Demographics
NPI:1336178904
Name:GRADY, PAULA MARIE (LM, CPM)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:GRADY
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2053 LONE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4620
Mailing Address - Country:US
Mailing Address - Phone:707-287-2822
Mailing Address - Fax:866-645-1206
Practice Address - Street 1:525 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3610
Practice Address - Country:US
Practice Address - Phone:707-287-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM198176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife