Active NPI
Auben Lin Elliott, PHD
- Psychologist
- Walnut Creek, CA
National Provider Identifier
1336358464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 11163
- Practice address
- 1844 San Miguel Dr
Walnut Creek, CA 94596-4962 - Phone
- (925) 367-5090
- NPI assigned
- May 22, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 11163 | CA | Primary |
Addresses
Primary practice location
1844 San Miguel Dr
Walnut Creek, CA 94596-4962
Mailing address
41 Fraser CT
Walnut Creek, CA 94596-5424
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 11163 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Services for Seniors, a Licensed Clinical Social Worker Co | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Oakland, CA
- NPI 1194030999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1336358464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 FRASER CT",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1844 SAN MIGUEL DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945964962",
"telephone_number": "925-367-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "AUBEN",
"middle_name": "LIN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 11163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.