Active NPI
Amanda Elizabeth Gibbon
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1689802472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 51387
- Practice address
- 8750 Mountain Blvd BLDG 69
Oakland, CA 94605-4500 - Phone
- (510) 317-1444
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 51387 | CA | Primary |
Addresses
Primary practice location
8750 Mountain Blvd BLDG 69
Oakland, CA 94605-4500
Mailing address
8750 Mountain Blvd BLDG 69
Oakland, CA 94605-4500
Phone (510) 317-1444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 9, 2025 through Jul 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51387 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1689802472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8750 MOUNTAIN BLVD BLDG 69",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946054500",
"telephone_number": "510-317-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8750 MOUNTAIN BLVD BLDG 69",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946054500",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBON",
"first_name": "AMANDA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "51387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.