Active NPI
Kathleen Peerson
- Mental Health Counselor
- San Rafael, CA
National Provider Identifier
1164690541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 914 Mission Ave FL 3
San Rafael, CA 94901-6106 - Phone
- (415) 457-6964
- NPI assigned
- Feb 19, 2008
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
914 Mission Ave FL 3
San Rafael, CA 94901-6106
Mailing address
82 Front Strret
Healdsburg, CA 95448
Phone (707) 433-1124
Other names 1
- Mrs. Kathleen Beamer
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203379200000",
"number": "1164690541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 FRONT STRRET",
"city": "HEALDSBURG",
"state": "CA",
"postal_code": "95448",
"telephone_number": "707-433-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 MISSION AVE FL 3",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949016106",
"telephone_number": "415-457-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEERSON",
"first_name": "KATHLEEN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-19",
"last_updated": "2008-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "BEAMER",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.