Active NPI
Brian Keith Wolff
- Addiction (Substance Use Disorder) Counselor
- Vallejo, CA
National Provider Identifier
1144841271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 10467
- Practice address
- 627 Grant St
Vallejo, CA 94590-7228 - Phone
- (707) 553-1042
- NPI assigned
- Apr 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 10467 | CA | Primary |
Addresses
Primary practice location
627 Grant St
Vallejo, CA 94590-7228
Mailing address
1045 George St #B
Vallejo, CA 94590
Phone (707) 246-1689
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 67574 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | houseofactsad@comcast.net | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 10467 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| House of Acts | Past | Accepting new patients |
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.
-
- Substance Abuse Rehabilitation Facility
- Vallejo, CA
- NPI 1326352188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1144841271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 GEORGE ST #B",
"city": "VALLEJO",
"state": "CA",
"postal_code": "94590",
"telephone_number": "707-246-1689",
"fax_number": "707-553-8146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "627 GRANT ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945907228",
"telephone_number": "707-553-1042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFF",
"first_name": "BRIAN",
"middle_name": "KEITH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "10467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "67574",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "houseofactsad@comcast.net",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "627 Grant St",
"city": "Vallejo",
"state": "CA",
"country_code": "US",
"postal_code": "945907228",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.