Ilka Louise De Gast, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY24409 Issued in CA

Practice address

3569 Round Barn Cir
Santa Rosa, CA 95403-1757

Phone

(707) 547-2222

Fax

(707) 527-0472

NPI assigned

Feb 4, 2011

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

Enrolled in CA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1649576851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031757",
            "telephone_number": "707-547-2222",
            "fax_number": "707-527-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031757",
            "telephone_number": "707-547-2222",
            "fax_number": "707-527-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GAST",
        "first_name": "ILKA",
        "middle_name": "LOUISE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSB33686",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY24409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alanna Dawkins
• Bonnie Jean Day, NP
• Jillian Day, AMFT
• Danielle J Daye
• Hailey Briana De Angelo
• Carla De la Chapelle
• Rudolpho Eduardo De la O, RAS
• De la Rosa Psychotherapists, a MFT Corporation
• Tatra-Li De la Rosa
• Jennifer De Los Santos

• Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.