Jason Dean Galbraith, R1558470424

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1558470424 Issued in CA

Practice address

16542 Silktree St
Fountain Valley, CA 92708-2347

Phone

(714) 715-9096

NPI assigned

May 9, 2024

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1700634144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16542 SILKTREE ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082347",
            "telephone_number": "714-715-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16542 SILKTREE ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082347",
            "telephone_number": "714-715-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALBRAITH",
        "first_name": "JASON",
        "middle_name": "DEAN",
        "credential": "R1558470424",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1558470424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FV Medical Supplies, Inc.
• FV Physical Medicine
• Douglas S Gahn, DC
• Jason Joseph Gajarsa, M.D.
• Angelica Galarza
• Guadalupe Virginia Galindo Martinez, MSW, ASW
• Guadalupe Liset Gallegos, MSW
• Carlie Dayle Galloway, LCSW
• Stacey L Galvin, LMFT #40424
• Tiffany Galvizo

• Addiction (Substance Use Disorder) Counselor in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.