Individual provider Active NPI

Simardeep Bhaurla, LPCC

  • Rehabilitation Counselor
  • Palo Alto, CA
National Provider Identifier
1669964730
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation CounselorTaxonomy code 225C00000X
Practice address
4139 El Camino Way
Palo Alto, CA 94306-4010
Phone
(650) 484-1376
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Rehabilitation Counselor 225C00000X Primary

Addresses

Primary practice location

4139 El Camino Way
Palo Alto, CA 94306-4010

Mailing address

1922 The Alameda
San Jose, CA 95126-1457
Phone (650) 484-1376

Other identifiers 1

IdentifierTypeStateIssuer
N05293OtherMEDICAL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250728003229 CA Practitioner - Mental Health Counselor 5698282390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jun 30, 2025 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Jun 30, 2025 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2001 Junipero Serra Blvd
Ste 500
Daly City, CA 94014
Phone (650) 746-1635

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 3

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1669964730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261457",
            "telephone_number": "650-484-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 EL CAMINO WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064010",
            "telephone_number": "650-484-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAURLA",
        "first_name": "SIMARDEEP",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "N05293",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.