Selam Habte Gebrekristos

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

123796 Issued in CA

Practice address

5365 Redding Rd
San Diego, CA 92115-1120

Phone

(619) 788-4628

NPI assigned

Jan 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1700475357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5365 REDDING RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151120",
            "telephone_number": "619-788-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5365 REDDING RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151120",
            "telephone_number": "619-788-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREKRISTOS",
        "first_name": "SELAM",
        "middle_name": "HABTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Christine Gebauer, PA
• Madison Gabrielle Gebhardt
• Kendra Gebhart
• Kibrom Ogbai Gebregziabher, LMFT
• Binyam Gebregziaber Gebrehiwot I
• Luel H Gebremeskel
• Nashwa Noel Gebri
• Madalyn Kristine Geddie
• Pamela Geddis, M.D.
• Bertha Mei Gee-Lew, M.D.

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.