Active NPI
Charles Bauman
- Mental Health Counselor
- San Jose, CA
National Provider Identifier
1255612305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 49830
- Practice address
- 6529 Crown Blvd Ste D
San Jose, CA 95120-2905 - Phone
- (831) 431-0346
- NPI assigned
- Sep 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 49830 | CA | Primary |
Addresses
Primary practice location
6529 Crown Blvd Ste D
San Jose, CA 95120-2905
Mailing address
219 Van Ness Ave
Santa Cruz, CA 95060-3535
Phone (831) 431-0346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49830 | Other | CA | MARRIAGE FAMILY THERAPIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49830 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314921600000",
"number": "1255612305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 VAN NESS AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950603535",
"telephone_number": "831-431-0346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6529 CROWN BLVD STE D",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951202905",
"telephone_number": "831-431-0346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMAN",
"first_name": "CHARLES",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-02",
"last_updated": "2011-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "49830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE FAMILY THERAPIST",
"identifier": "49830",
"state": "CA"
}
],
"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 Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.