Active NPI
Shant Gavgavian
- Counselor
- Novato, CA
National Provider Identifier
1679255756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 201 Alameda del Prado
Novato, CA 94949-6688 - Phone
- (415) 457-6964
- NPI assigned
- Aug 7, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
201 Alameda del Prado
Novato, CA 94949-6688
Mailing address
201 Alameda del Prado
Novato, CA 94949-6688
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buckelew Programs | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Santa Rosa, CA
- NPI 1497587240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1679255756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 ALAMEDA DEL PRADO",
"city": "NOVATO",
"state": "CA",
"postal_code": "949496688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 ALAMEDA DEL PRADO",
"city": "NOVATO",
"state": "CA",
"postal_code": "949496688",
"telephone_number": "415-457-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVGAVIAN",
"first_name": "SHANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-07",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.