Randolph Chambers

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

410027AN Issued in CA

Practice address

1796 Bay Rd
East Palo Alto, CA 94303-1611

Phone

(650) 462-6999

Fax

(650) 462-1055

NPI assigned

Mar 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Free at Last Center

  • Counselor
  • East Palo Alto, CA
  • NPI 1063849735
  NPD (past)
• Free at Last:Community Recovery and Rehabilitation Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • East Palo Alto, CA
  • NPI 1679868715
  NPD (past)

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1336463397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-462-6999",
            "fax_number": "650-462-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1796 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-462-6999",
            "fax_number": "650-462-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "410027AN",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "4100274LN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WILLIAMSHOUSE I &II",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WALKERHOUSE2",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlos Joan Camargo
• Veronica Cardenas
• Leticia Cardiel
• Sheila Castrillo
• Juanita Cervantes, NONE
• Neha Vinay Chandra, MD
• Chauncey Peter Lamar Chatman, M.A., MFT
• Jaime Chavarria, MD
• Juan Manuel Chavez, R.N.
• Elizabeth Chewning

• Addiction (Substance Use Disorder) Counselor in East Palo Alto, CA
• Providers in East Palo Alto, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.