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Deactivated NPI 1104005115 Deactivated / Inactive NPI Male Practitioner

Mitchell Grant

Specialist • Oakland, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mitchell Grant has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 25, 2007
NPI Deactivation Date January 23, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Mitchell Grant was a registered Specialist practicing in Oakland, CA. Throughout an active medical career spanning 18 years, Mitchell Grant provided care at the practice location at 6333 TELEGRAPH AVE STE 102 until profile deactivation on 2025-01-23.

Practice Location & Contact Primary Location

Practice Address

6333 Telegraph Ave Ste 102

Oakland, CA 946091359

Telephone 5109231099
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Oakland, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.2 Yrs
State Avg: 38.0 Yrs
Regional Practice Density
212 Specialists

Practicing in Oakland, CA (6446 Statewide)

Telehealth Adoption Rate
0.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Bryan Hope

Behavior Analyst

NPI 1003433038
Senobia Ellis

Counselor - Mental Health

NPI 1013672468
Ronnie Murray

Counselor - Mental Health

NPI 1023657368
Justin Colwell , LCSW

Social Worker - Clinical

NPI 1033577531

Licensed Clinical Social Worker

Sheryl Perdue

Specialist

NPI 1043567258
Toska Mcqueen

Counselor

NPI 1073188173

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 23, 2025

Record deactivated on January 23, 2025

NPI Profile Active October 25, 2007

NPI status registered as active in NPPES database

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Updated Practice Location October 25, 2007

Registered at 6333 TELEGRAPH AVE STE 102, OAKLAND, CA 946091359 (Tel: 5109231099)

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Updated Business Mailing Address October 25, 2007

Registered at 6333 TELEGRAPH AVE STE 102, OAKLAND, CA 946091359

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Provider Name / Credentials Updated October 25, 2007

Recorded as MITCHELL GRANT

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 25, 2007

Specialist

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Initial NPI Registration & Enumeration October 25, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104005115
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 25, 2007
Last Update: October 25, 2007
Deactivation Date: January 23, 2025

Mailing Address

6333 Telegraph Ave Ste 102

Oakland, CA 946091359

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.