Individual provider Active NPI

Laurie Gottlieb

  • Health & Wellness Coach
  • Fairfax, CA
National Provider Identifier
1619852449
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
85 Bolinas Rd Ste 5
Fairfax, CA 94930-1626
Phone
(415) 760-6108
Fax
(888) 226-7020
NPI assigned
Aug 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X CA
Health & Wellness Coach 171400000X CA Primary

Addresses

Primary practice location

85 Bolinas Rd Ste 5
Fairfax, CA 94930-1626

Mailing address

159 W Oak Knoll Dr
San Anselmo, CA 94960-1175
Phone (415) 760-6108

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": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1619852449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W OAK KNOLL DR",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601175",
            "telephone_number": "415-760-6108",
            "fax_number": "415-760-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BOLINAS RD STE 5",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301626",
            "telephone_number": "415-760-6108",
            "fax_number": "888-226-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "LAURIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.