Active NPI
Jessica Krauth, LPCC
- Mental Health Counselor
- Livermore, CA
National Provider Identifier
1023524857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13455
- Practice address
- 1615 2ND St
Livermore, CA 94550-4327 - Phone
- (925) 456-4420
- NPI assigned
- Dec 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 13455 | CA | Primary |
Addresses
Primary practice location
1615 2ND St
Livermore, CA 94550-4327
Mailing address
1615 2ND St
Livermore, CA 94550-4327
Phone (925) 456-4420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 25, 2024 through Jan 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13455 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1023524857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 2ND ST",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504327",
"telephone_number": "925-456-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 2ND ST",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504327",
"telephone_number": "925-456-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAUTH",
"first_name": "JESSICA",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-15",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "13455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.