Individual ProviderJohn L. GrahmPsychologistBehavioral Health & Social Service ProvidersPractice Address360 Mobil Ave, 211d, Camarillo, CA 93010-6325(805) 654-5671(805) 529-3644PECOS EnrollmentBased on the most recent information from CMS, provider John L. Grahm 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 5 days ago.Profile DetailsProvider ID1548347909Provider TypeIndividualFull NameGrahm, John L.TitleDr.CredentialPH.D.GenderMaleSole ProprietorYesEnumeration Date11/1/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address360 Mobil Ave, 211d, Camarillo, CA 93010-6325Phone(805) 654-5671Fax(805) 529-5421Mailing LocationMailing Address3362 Cajon Cir, Santa Rosa Valley, CA 93012-8223Phone(805) 529-3644Fax(805) 529-5421Provider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicensePSY5296California