Active NPI
Andrea Sara Pearson-Gottlieb
- Counselor
- Eureka, CA
National Provider Identifier
1467966994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMF100039
- Practice address
- 1802 California St
Eureka, CA 95501-2808 - Phone
- (707) 433-7358
- Fax
- (707) 443-1092
- NPI assigned
- Nov 20, 2017
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMF100039 | CA | Primary |
Addresses
Primary practice location
1802 California St
Eureka, CA 95501-2808
Mailing address
1802 California St
Eureka, CA 95501-2808
Phone (707) 433-7358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-1511575 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF100039 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511136000000",
"number": "1467966994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 CALIFORNIA ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955012808",
"telephone_number": "707-433-7358",
"fax_number": "707-443-1092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 CALIFORNIA ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955012808",
"telephone_number": "707-433-7358",
"fax_number": "707-443-1092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON-GOTTLIEB",
"first_name": "ANDREA",
"middle_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-20",
"last_updated": "2017-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": "CA",
"license": "IMF100039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94-1511575",
"state": "CA"
}
],
"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 Nov 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.