Active NPI
Callie Gregg
- Addiction (Substance Use Disorder) Counselor
- San Jose, CA
National Provider Identifier
1134517220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- RI-G1307201216
- Practice address
- 1340 Tully Rd.
304
San Jose, CA 95122 - Phone
- (408) 271-3960
- Fax
- (408) 271-3909
- NPI assigned
- Dec 26, 2014
- Last updated
- Dec 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RI-G1307201216 | CA | Primary |
Addresses
Primary practice location
1340 Tully Rd.
304
San Jose, CA 95122
Mailing address
40 Tully Rd.
304
San Jose, CA 95122
Phone (408) 271-3960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RI-G1307201216 | Other | CA | RASI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RI-G1307201216 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419552000000",
"number": "1134517220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 TULLY RD.",
"address_2": "304",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95122",
"telephone_number": "408-271-3960",
"fax_number": "408-271-3909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 TULLY RD.",
"address_2": "304",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95122",
"telephone_number": "408-271-3960",
"fax_number": "408-271-3909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGG",
"first_name": "CALLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-26",
"last_updated": "2014-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RI-G1307201216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RASI",
"identifier": "RI-G1307201216",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.