Individual provider Active NPI

William Michael Gordon, B.S.

  • Mental Health Counselor
  • Orange, CA
National Provider Identifier
1376784363
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
301 The City Dr S # 2090
Orange, CA 92868-3205
Phone
(714) 935-6719
Fax
(714) 935-8112
NPI assigned
Mar 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

301 The City Dr S # 2090
Orange, CA 92868-3205

Mailing address

405 W 5TH St # 590
Santa Ana, CA 92701-4599
Phone (714) 834-5015

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
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1376784363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST # 590",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-834-5015",
            "fax_number": "714-834-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 THE CITY DR S # 2090",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683205",
            "telephone_number": "714-935-6719",
            "fax_number": "714-935-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.