Individual provider Active NPI

Alyse Gabriel, D.O.

  • Psychiatry Physician
  • East Palo Alto, CA
National Provider Identifier
1053329144
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A8893 Issued in CA
Practice address
2415 University Ave
3Rd Floor
East Palo Alto, CA 94303-1164
Phone
(650) 363-4030
NPI assigned
Aug 4, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A8893 CA Primary

Addresses

Primary practice location

2415 University Ave
3Rd Floor
East Palo Alto, CA 94303-1164

Mailing address

2415 University Ave
3Rd Floor
East Palo Alto, CA 94303-1164
Phone (650) 363-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080129000235 CA Practitioner - Osteopathic Manipulative Medicine 0941382055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone (650) 573-2222

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 573-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8893CAMDAddiction (Substance Use Disorder) Counselor
20A8893CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Dec 5, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
San Mateo County Psychiatry CurrentSince Dec 5, 2016 Accepting new patients
San Mateo County Health System BHRS Past Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8648

2415 University Ave
East Palo Alto, CA 94303
Phone (650) 363-4030

2415 University Ave
Ste 3
East Palo Alto, CA 94303
Phone (650) 363-4030

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1053329144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE",
            "address_2": "3RD FLOOR",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031164",
            "telephone_number": "650-363-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE",
            "address_2": "3RD FLOOR",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031164",
            "telephone_number": "650-363-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "ALYSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A8893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.