Gloria Lorraine Van Bree, PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSY10608 Issued in CA

Practice address

445 Burgess Dr
#150
Menlo Park, CA 94025-3442

Phone

(650) 964-7774

Fax

(650) 657-9434

NPI assigned

Nov 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1258761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258761600000",
    "number": "1629306196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 BURGESS DR",
            "address_2": "#150",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253442",
            "telephone_number": "650-964-7774",
            "fax_number": "650-657-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BURGESS DR",
            "address_2": "#150",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253442",
            "telephone_number": "650-964-7774",
            "fax_number": "650-657-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BREE",
        "first_name": "GLORIA",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-21",
        "last_updated": "2009-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY10608",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY10608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Vaida
• Jeremy Andrew Vail, PT
• Helen Valenstein, PHD
• Jason Valerio, MD
• Michael P Vallario, PSY.D.
• John Wayne Van Natta, MD
• Joellen Lee Vanzander, MD
• Ashwini Vartak
• Margaret Anne Vartanian, M.D.
• Marina Vaserman, M.A.

• Mental Health Counselor in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.