Active NPI
Micheal Ford
- Addiction (Substance Use Disorder) Counselor
- Fremont, CA
National Provider Identifier
1639943533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1533341023
- Practice address
- 3155 Kearney St
Fremont, CA 94538-2268 - Phone
- (800) 846-1652
- NPI assigned
- Nov 10, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1533341023 | CA | Primary |
Addresses
Primary practice location
3155 Kearney St
Fremont, CA 94538-2268
Mailing address
71 Driftwood Cir
Bay Point, CA 94565-1378
Phone (510) 517-0244
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1533341023 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1639943533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 DRIFTWOOD CIR",
"city": "BAY POINT",
"state": "CA",
"postal_code": "945651378",
"telephone_number": "510-517-0244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3155 KEARNEY ST",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382268",
"telephone_number": "800-846-1652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "MICHEAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-10",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1533341023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.