Michael Bogren

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A02820315 Issued in CA

Practice address

1400 Emeline St
BLDG K (3Rd Floor)
Santa Cruz, CA 95060-5320

Phone

(831) 454-7435

Fax

(831) 454-4747

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149
  NPD (past)
• Santa Cruz County

  • Community/Behavioral Health Agency
  • Santa Cruz, CA
  • NPI 1164978557
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1013133644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE ST",
            "address_2": "BLDG K (3RD FLOOR)",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605320",
            "telephone_number": "831-454-7435",
            "fax_number": "831-454-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE ST",
            "address_2": "BLDG K (3RD FLOOR)",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605320",
            "telephone_number": "831-454-7435",
            "fax_number": "831-454-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Harvey West Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950602126",
            "country_code": "US",
            "telephone_number": "831-469-1700 x140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGREN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A02820315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ91892Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nick Bobeda
• Stephanie M Bodisco
• Jordan Michael Boerner, DTCM, LAC
• Oksana Bogatko
• John Bredin Boggs, ACNP
• Kellie Bohlke, BCBA
• Maria V Boisa
• Emily Ann Bollin
• Jonathan Thomas Bolosan
• Beloved Bolton

• Addiction (Substance Use Disorder) Counselor in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.