Individual provider Active NPI

Anna Marie Lau, CADC-II, WTS

  • Case Manager/Care Coordinator
  • San Jose, CA
National Provider Identifier
1184228918
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1046 W Taylor St Ste 206
San Jose, CA 95126-1815
Phone
(408) 596-4830
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X WTS05141020 CA
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X A051790520 CA
Case Manager/Care Coordinator 171M00000X CA Primary

Addresses

Primary practice location

1046 W Taylor St Ste 206
San Jose, CA 95126-1815

Mailing address

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 261-7777

Other practice location 1

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 261-7777

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
WTS05141020CAMDCounselor
A051790520CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Live With Purpose, LLC Addiction (Substance Use Disorder) CurrentSince Jan 10, 2021 Accepting new patients

Locations

1046 W Taylor St
Ste 206
San Jose, CA 95126
Phone (408) 596-4830

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.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1184228918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261136",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 W TAYLOR ST STE 206",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261815",
            "telephone_number": "408-596-4830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951261136",
            "country_code": "US",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAU",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "CADC-II, WTS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "WTS05141020",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A051790520",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 6, 2021; 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.