Individual provider Active NPI

Timothy Scott Schipke, MFTI

  • Student in an Organized Health Care Education/Training Program
  • San Mateo, CA
National Provider Identifier
1245589027
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
IMF76289 Issued in CA
Practice address
2600 S El Camino Real
Suite 200
San Mateo, CA 94403-2380
Phone
(650) 372-4080
NPI assigned
Sep 7, 2012
Last updated
Jun 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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 NU
Student in an Organized Health Care Education/Training Program 390200000X IMF76289 CA Primary

Addresses

Primary practice location

2600 S El Camino Real
Suite 200
San Mateo, CA 94403-2380

Mailing address

PO Box 411331
San Francisco, CA 94141-1331
Phone (415) 298-6663

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
IMF76289CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1245589027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411331",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941411331",
            "telephone_number": "415-298-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S EL CAMINO REAL",
            "address_2": "SUITE 200",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032380",
            "telephone_number": "650-372-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIPKE",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "IMF76289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.