Active NPI
Tina Elaine Engel
- Mental Health Counselor
- Campbell, CA
National Provider Identifier
1427378546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1079 Audrey Ave
Campbell, CA 95008-6402 - Phone
- (408) 379-0639
- NPI assigned
- Jun 11, 2010
- Last updated
- Jun 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
1079 Audrey Ave
Campbell, CA 95008-6402
Mailing address
1420 San Tomas Aquino Rd
San Jose, CA 95130-1131
Phone (916) 838-9878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
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": "1276214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276214400000",
"number": "1427378546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 SAN TOMAS AQUINO RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951301131",
"telephone_number": "916-838-9878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1079 AUDREY AVE",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950086402",
"telephone_number": "408-379-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGEL",
"first_name": "TINA",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-11",
"last_updated": "2010-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.