Individual ProviderGina Mia Di GraziaRehabilitation CounselorRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address165 1/2 Chattanooga St, San Francisco, CA 94114-3438(415) 846-6266PECOS EnrollmentBased on the most recent information from CMS, provider Gina Mia Di Grazia does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:50 PM.Profile DetailsProvider ID1427188838Provider TypeIndividualFull NameDi Grazia, Gina MiaTitleMs.CredentialOTR/L, COMS, CLVTGenderFemaleSole ProprietorNoEnumeration Date3/6/2007Last Updated1/14/2016Contact InformationPractice LocationPractice Address165 1/2 Chattanooga St, San Francisco, CA 94114-3438Phone(415) 846-6266FaxUnlisted FaxMailing LocationMailing Address165 1/2 Chattanooga St, San Francisco, CA 94114-3438Phone(415) 846-6266FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225CX0006XPrimaryDescriptionRehabilitation CounselorRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseAVCREP CERT. 4898Code225X00000XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseOT5361CaliforniaCode225XL0004XDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseOT 5361CaliforniaProvider IdentifiersIDDescriptionIssuerIDOT 5361DescriptionOtherIssuerCA BOARD OF OTCaliforniaID5466DescriptionOtherIssuerACVREPID4898DescriptionOtherIssuerACVREP