Individual provider Active NPI

Jeffrey Martin Nilsen, AOD COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • San Francisco, CA
National Provider Identifier
1376736926
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
350 Townsend St
Suite 205
San Francisco, CA 94107-1697
Phone
(415) 905-5555
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA Primary

Addresses

Primary practice location

350 Townsend St
Suite 205
San Francisco, CA 94107-1697

Mailing address

350 Townsend St
Suite 205
San Francisco, CA 94107-1697
Phone (415) 905-5555

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

Practice roles

OrganizationSpecialtyStatusNew patients
Driver Performance Institutes, Inc. Past Accepting new patients
Driver Performance Institutes, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1376736926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 TOWNSEND ST",
            "address_2": "SUITE 205",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941071697",
            "telephone_number": "415-905-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 TOWNSEND ST",
            "address_2": "SUITE 205",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941071697",
            "telephone_number": "415-905-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSEN",
        "first_name": "JEFFREY",
        "middle_name": "MARTIN",
        "credential": "AOD COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.