Active NPI
Antonio Casillas, MA
- Professional Counselor
- Oakland, CA
National Provider Identifier
1528575636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APCC6119
- Practice address
- 2579 San Pablo Ave
Oakland, CA 94612-1159 - Phone
- (510) 446-7100
- NPI assigned
- Jan 10, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APCC6119 | CA | Primary |
Addresses
Primary practice location
2579 San Pablo Ave
Oakland, CA 94612-1159
Mailing address
2579 San Pablo Ave
Oakland, CA 94612-1159
Phone (510) 446-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APCC6119 | Other | CA | ASSOCIATE PROFESSIONAL CLINICAL COUNSELOR |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APCC6119 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552435200000",
"number": "1528575636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2579 SAN PABLO AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946121159",
"telephone_number": "510-446-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2579 SAN PABLO AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946121159",
"telephone_number": "510-446-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASILLAS",
"first_name": "ANTONIO",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-10",
"last_updated": "2019-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "APCC6119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOCIATE PROFESSIONAL CLINICAL COUNSELOR",
"identifier": "APCC6119",
"state": "CA"
}
],
"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 Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.