Provider Demographics
NPI:1467248476
Name:GRANDIS, BENJAMIN R (NBHWC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:R
Last Name:GRANDIS
Suffix:
Gender:
Credentials:NBHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 LEAVENWORTH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6035
Mailing Address - Country:US
Mailing Address - Phone:412-310-2876
Mailing Address - Fax:
Practice Address - Street 1:725 LEAVENWORTH ST APT 8
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6035
Practice Address - Country:US
Practice Address - Phone:412-310-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach