Individual provider Active NPI

Revi Hope Airborne- Williams, LMFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1801080379
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114680 Issued in CA
Practice address
445 Bellevue Ave Ste 1
Oakland, CA 94610-4923
Phone
(510) 394-2626
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 88694 CA
Marriage & Family Therapist 106H00000X 114680 CA Primary

Addresses

Primary practice location

445 Bellevue Ave Ste 1
Oakland, CA 94610-4923

Mailing address

445 Bellevue Ave Ste 1
Oakland, CA 94610-4923
Phone (510) 394-2626

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

State licenses

LicenseStateTypeSpecialty
114680CAMDMarriage & Family Therapist
88694CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1801080379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 BELLEVUE AVE STE 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104923",
            "telephone_number": "510-394-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BELLEVUE AVE STE 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104923",
            "telephone_number": "510-394-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIRBORNE- WILLIAMS",
        "first_name": "REVI",
        "middle_name": "HOPE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "88694",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114680",
            "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 Sep 18, 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.