Active NPI
Michelle Gibbons
- Rehabilitation Practitioner
- Eureka, CA
National Provider Identifier
1407517170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 310 3Rd St
Eureka, CA 95501-0492 - Phone
- (707) 467-2010
- NPI assigned
- Jan 5, 2022
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
310 3Rd St
Eureka, CA 95501-0492
Mailing address
PO Box 2077
Ukiah, CA 95482-2077
Phone (707) 467-2010
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": "1641340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407517170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2077",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822077",
"telephone_number": "707-467-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 3RD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955010492",
"telephone_number": "707-467-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2022-01-05",
"last_updated": "2026-07-13",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.