Active NPI
Andrea Neda Anjomshoaa
- Counselor
- Berkeley, CA
National Provider Identifier
1811146673
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 120 Haviland Hall SPC 7400
Berkeley, CA 94720-7400 - Phone
- (510) 642-4341
- NPI assigned
- Sep 16, 2008
- Last updated
- Apr 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 80921 | CA |
Addresses
Primary practice location
120 Haviland Hall SPC 7400
Berkeley, CA 94720-7400
Mailing address
2784 McAllister St
San Francisco, CA 94118-4115
Phone (626) 488-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80291 | Other | CA | LCSW |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556496000000",
"number": "1811146673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2784 MCALLISTER ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941184115",
"telephone_number": "626-488-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 HAVILAND HALL SPC 7400",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947207400",
"telephone_number": "510-642-4341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANJOMSHOAA",
"first_name": "ANDREA",
"middle_name": "NEDA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2019-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "80921",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "80291",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.