GRACEVINE HEALTHCARE SVCS A PROFESSNAL NURSING CORP
NPI 1255050084
Nurse Practitioner - Family in San Bernardino, CA
About Gracevine Healthcare Svcs A Professnal Nursing Corp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRACEVINE HEALTHCARE SVCS A PROFESSNAL NURSING CORP (NPI 1255050084) is a healthcare organization registered as a family in San Bernardino, California and active in the NPI registry since August 2022. The organization lists Oluwayemisi Daramola, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN BERNADINO, CA 92408
SAN BERNARDINO, CA 92408
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gracevine Healthcare Svcs A Professnal Nursing Corp's NPI number?
The NPI number for Gracevine Healthcare Svcs A Professnal Nursing Corp is 1255050084. It was assigned to this organization in the NPPES registry on August 24, 2022.
Where is Gracevine Healthcare Svcs A Professnal Nursing Corp located?
Gracevine Healthcare Svcs A Professnal Nursing Corp is located at 473 E Carnegie Dr Ste 200, San Bernardino, CA 92408. The listed phone number is (909) 743-1300.
What is Gracevine Healthcare Svcs A Professnal Nursing Corp's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
When was this NPI record last updated?
The NPPES record for Gracevine Healthcare Svcs A Professnal Nursing Corp was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gracevine Healthcare Svcs A Professnal Nursing Corp · NPI 1255050084
Family organization in San Bernardino, California. Organization record, active in the CMS NPPES registry since August 24, 2022.
## Identity
- **NPI:** 1255050084 (Entity type: Organization)
- **Enumerated:** August 24, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Oluwayemisi Daramola, OWNER
## Practice location
- **Address:** 473 E CARNEGIE DR STE 200, San Bernardino, CA 92408-4201
- **Phone:** (909) 743-1300
## Record status
- **NPPES last updated:** May 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1255050084) · Data from the CMS NPPES public registry.