Individual provider Active NPI

Andrea Anderson

  • Counselor
  • San Francisco, CA
National Provider Identifier
1710397401
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1153 Oak St
San Francisco, CA 94117-2216
Phone
(702) 735-9755
Fax
(415) 431-1813
NPI assigned
May 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Counselor 101Y00000X CA Primary

Addresses

Primary practice location

1153 Oak St
San Francisco, CA 94117-2216

Mailing address

1153 Oak St
San Francisco, CA 94117-2216
Phone (702) 735-9755

Other practice location 1

2075 Lincoln Ave Ste D
San Jose, CA 95125-3513
Phone (855) 295-3276

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

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1710397401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 OAK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172216",
            "telephone_number": "702-735-9755",
            "fax_number": "415-431-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 OAK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172216",
            "telephone_number": "702-735-9755",
            "fax_number": "415-431-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2075 Lincoln Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951253513",
            "country_code": "US",
            "telephone_number": "855-295-3276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.