Active NPI
Elizabeth Gadomski, PSY.D.
- Counselor
- Oakland, CA
National Provider Identifier
1174742480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 4001 Howe St
Oakland, CA 94611-5211 - Phone
- (415) 890-3995
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4001 Howe St
Oakland, CA 94611-5211
Mailing address
4001 Howe St
Oakland, CA 94611-5211
Phone (917) 568-1564
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9562 | Other | SFGH INTERNAL USE ONLY | |
| 9562 | Other | CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER | |
| 390200000X | Other | CA | STUDENT, HEALTH CARE |
Other names 1
- Dr. Elizabeth Gadomski Krimstock
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23658 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1174742480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 HOWE ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115211",
"telephone_number": "917-568-1564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 HOWE ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115211",
"telephone_number": "415-890-3995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADOMSKI",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SFGH INTERNAL USE ONLY",
"identifier": "9562",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
"identifier": "9562",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STUDENT, HEALTH CARE",
"identifier": "390200000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "KRIMSTOCK",
"middle_name": "GADOMSKI",
"prefix": "DR.",
"credential": "PSY.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.