Active NPI
Elaina Ealycorasmith
- Counselor
- Fairfield, CA
National Provider Identifier
1487973020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1735 Enterprise Dr
Suite 105a BLDG.1
Fairfield, CA 94533-6822 - Phone
- (707) 425-1799
- NPI assigned
- May 21, 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1735 Enterprise Dr
Suite 105a BLDG.1
Fairfield, CA 94533-6822
Mailing address
2534 San Fernando Way
Aprt. 2
Sacramento, CA 95818-2759
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": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1487973020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2534 SAN FERNANDO WAY",
"address_2": "APRT. 2",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958182759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 ENTERPRISE DR",
"address_2": "SUITE 105A BLDG.1",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945336822",
"telephone_number": "707-425-1799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EALYCORASMITH",
"first_name": "ELAINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-21",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.