Active NPI
Cliff Gahagan
- Addiction (Substance Use Disorder) Counselor
- San Jose, CA
National Provider Identifier
1376974360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 398 S 12TH St
San Jose, CA 95112-2228 - Phone
- (408) 297-7702
- Fax
- (408) 297-7705
- NPI assigned
- Dec 2, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
398 S 12TH St
San Jose, CA 95112-2228
Mailing address
398 S 12TH St
San Jose, CA 95112-2228
Phone (408) 297-7702
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": "1385942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1376974360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "398 S 12TH ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951122228",
"telephone_number": "408-297-7702",
"fax_number": "408-297-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "398 S 12TH ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951122228",
"telephone_number": "408-297-7702",
"fax_number": "408-297-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAHAGAN",
"first_name": "CLIFF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-02",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.