Individual provider Active NPI

B L. Elliott

  • Rehabilitation Psychologist
  • San Francisco, CA
National Provider Identifier
1003014739
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Practice address
747 Front St
San Francisco, CA 94111-1945
Phone
(707) 508-6341
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X Primary

Addresses

Primary practice location

747 Front St
San Francisco, CA 94111-1945

Mailing address

PO Box 9041
Santa Rosa, CA 95405-1041
Phone (707) 508-6341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1003014739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9041",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954051041",
            "telephone_number": "707-508-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 FRONT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941111945",
            "telephone_number": "707-508-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "B",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.