Individual provider Active NPI

Joshua Crum

  • Mental Health Counselor
  • San Pablo, CA
National Provider Identifier
1457967242
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
103 Villa Dr
San Pablo, CA 94806-3768
Phone
(510) 717-4564
NPI assigned
Sep 17, 2020
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

103 Villa Dr
San Pablo, CA 94806-3768

Mailing address

103 Villa Dr
San Pablo, CA 94806-3768
Phone (510) 717-4564

Other practice location 1

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone (510) 352-0336

Other practice location 2

545 Estudillo Ave
San Leandro, CA 94577-4611
Phone (510) 746-7480

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

Practice roles

OrganizationSpecialtyStatusNew patients
Art of Care Therapy, a Marriage & Family Therapy Co. CurrentSince Jan 28, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1457967242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 VILLA DR",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063768",
            "telephone_number": "510-717-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 VILLA DR",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063768",
            "telephone_number": "510-717-4564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Estudillo Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774962",
            "country_code": "US",
            "telephone_number": "510-352-0336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 Estudillo Ave",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774611",
            "country_code": "US",
            "telephone_number": "510-746-7480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUM",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-17",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.