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DR. LARISSA ANNE GRACE M.D.
NPI 1366671596
Psychiatry & Neurology - Child & Adolescent Psychiatry in Pomona, CA

Active since July 09, 2009PECOS Enrolled
1900 ROYALTY DR STE 180, POMONA, CA 91767(909) 784-3200(909) 865-0730 Get Directions Write a Review

NPPES record last updated: September 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Larissa Anne Grace M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LARISSA ANNE GRACE M.D. (NPI 1366671596) is an individual child & adolescent psychiatry provider in Pomona, California, licensed in California (A116676) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366671596
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. LARISSA ANNE GRACECredential: M.D.
Location Address1900 ROYALTY DR STE 180Pomona, CA 91767-3046
Mailing Address1900 Royalty Dr Ste 180Pomona, CA 91767-3046 · (909) 784-3200 · Fax (909) 865-0730
Phone(909) 784-3200
Fax(909) 865-0730
Sole ProprietorYes
Enumeration DateJuly 9, 2009
Last NPPES UpdateSeptember 29, 2015
✔ NPI 1366671596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in CA · A116676
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License A116676 (CA)
1900 ROYALTY DR STE 180, Pomona, CA 91767
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Larissa Anne Grace M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YVETTE BARRIGA
Marriage & Family Therapist
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
MS. STEPHANIE HERNANDEZ ENCISO LCSW
Social Worker (Clinical)
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
JENNIFER CHAHINE
Social Worker (Clinical)
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
KEITH COLDER
Peer Specialist
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
VAN MY TONG
Social Worker (Clinical)
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
JENNIFER RODRIGUEZ
Marriage & Family Therapist
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
MR. MICHAEL ANTHONY BANUELOS MSW
Social Worker (Clinical)
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7340
CYNTHIA GARCIA
Community Health Worker
1900 ROYALTY DR STE 180
POMONA, CA 91767
Los Angeles County (909) 766-7322

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 Larissa Grace's NPI number?

The NPI number for Larissa Grace is 1366671596. It was assigned to this individual provider in the NPPES registry on July 9, 2009.

Where is Larissa Grace located?

Larissa Grace practices at 1900 Royalty Dr Ste 180, Pomona, CA 91767. The listed phone number is (909) 784-3200.

What is Larissa Grace's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Larissa Grace enrolled in Medicare?

Yes. Larissa Grace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Larissa Grace was last updated on September 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.