Individual provider Active NPI

Gary Shurtz

  • Mental Health Counselor
  • Diamond Springs, CA
National Provider Identifier
1376940320
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4250 Fowler LN
Ste. 102
Diamond Springs, CA 95619-9781
Phone
(530) 626-3100
NPI assigned
Nov 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

4250 Fowler LN
Ste. 102
Diamond Springs, CA 95619-9781

Mailing address

3006 Courtside Dr
Diamond Springs, CA 95619-9271
Phone (530) 417-2874

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

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1376940320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 COURTSIDE DR",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199271",
            "telephone_number": "530-417-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FOWLER LN",
            "address_2": "STE. 102",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199781",
            "telephone_number": "530-626-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURTZ",
        "first_name": "GARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.