Active NPI
Ajay Deven Dave
- Mental Health Counselor
- Oakland, CA
National Provider Identifier
1457910911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 111613
- Practice address
- 2501 Harrison St
Oakland, CA 94612-3811 - Phone
- (510) 788-0876
- NPI assigned
- Jun 10, 2019
- Sex
- Male
- 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 | 111613 | CA | Primary |
Addresses
Primary practice location
2501 Harrison St
Oakland, CA 94612-3811
Mailing address
6129 Sutter Ave
Richmond, CA 94804-5301
Phone (941) 524-2371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111613 | CA | MD | Mental Health Counselor |
| 134431 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560124800000",
"number": "1457910911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6129 SUTTER AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948045301",
"telephone_number": "941-524-2371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 HARRISON ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946123811",
"telephone_number": "510-788-0876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVE",
"first_name": "AJAY",
"middle_name": "DEVEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-10",
"last_updated": "2019-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "111613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.