Individual provider Active NPI

Gabriella Kamara, APCC

  • Professional Counselor
  • Lake Forest, CA
National Provider Identifier
1609536051
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13602 Issued in CA
Practice address
23712 Birtcher Dr
Lake Forest, CA 92630-1771
Phone
(888) 830-8374
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X R1454011221 CA
Professional Counselor 101YP2500X 13602 CA Primary

Addresses

Primary practice location

23712 Birtcher Dr
Lake Forest, CA 92630-1771

Mailing address

310 N Alpine Dr
Beverly Hills, CA 90210-4929

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

LicenseStateTypeSpecialty
R1454011221CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Legends Healthcare LLC CurrentSince Sep 1, 2024 Accepting new patients
12 South LLC CurrentSince Nov 6, 2022 Accepting new patients

Locations

23712 Birtcher Dr
Lake Forest, CA 92630
Phone (888) 830-8374

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1609536051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N ALPINE DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23712 BIRTCHER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301771",
            "telephone_number": "888-830-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMARA",
        "first_name": "GABRIELLA",
        "credential": "APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "R1454011221",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "13602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.