Individual provider Active NPI

Gaelen Elizabeth Stevens-Nelson

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1164739405
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
74642. Issued in CA
Practice address
2550 23Rd St
Building 9, Room 130
San Francisco, CA 94110-3504
Phone
(415) 206-5270
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 74642. CA Primary

Addresses

Primary practice location

2550 23Rd St
Building 9, Room 130
San Francisco, CA 94110-3504

Mailing address

1266 14TH St
Oakland, CA 94607-2205
Phone (510) 531-3111

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

LicenseStateTypeSpecialty
74642.CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1164739405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 14TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946072205",
            "telephone_number": "510-531-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 23RD ST",
            "address_2": "BUILDING 9, ROOM 130",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103504",
            "telephone_number": "415-206-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS-NELSON",
        "first_name": "GAELEN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "74642.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.

Verify at the official NPI Registry.