Individual provider Active NPI

Rachel Gordon-Eldred, MFT

  • Mental Health Counselor
  • Chula Vista, CA
National Provider Identifier
1114285574
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44894 Issued in CA
Practice address
2257 Birds Nest LN
Chula Vista, CA 91915-1955
Phone
(858) 366-2198
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44894 CA Primary

Addresses

Primary practice location

2257 Birds Nest LN
Chula Vista, CA 91915-1955

Mailing address

4382 38TH St
San Diego, CA 92105-1013
Phone (858) 366-2198

Other names 1

  • Rachel Cassell Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913003122 CA Practitioner - Marriage and Family Therapist 3779023932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44894CAMDMental Health Counselor
48894CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Aug 6, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1114285574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 38TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051013",
            "telephone_number": "858-366-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 BIRDS NEST LN",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151955",
            "telephone_number": "858-366-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON-ELDRED",
        "first_name": "RACHEL",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2024-06-29",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "44894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "CASSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.