Individual provider Active NPI

Jan Levinson Gilman, PH.D.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1295925683
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 7020 Issued in CA
Practice address
718 Spring St
Santa Rosa, CA 95404-3902
Phone
(707) 483-8866
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY12926 CA
Marriage & Family Therapist 106H00000X MFT 7020 CA Primary

Addresses

Primary practice location

718 Spring St
Santa Rosa, CA 95404-3902

Mailing address

718 Spring St
Santa Rosa, CA 95404-3902
Phone (707) 483-8866

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12926CAMDClinical Psychologist
MFT 7020CAMDMarriage & Family Therapist
12926CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1295925683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 SPRING ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043902",
            "telephone_number": "707-483-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 SPRING ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043902",
            "telephone_number": "707-483-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "JAN",
        "middle_name": "LEVINSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12926",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 7020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.