Active NPI
Christopher Thomas Bordeaux
- Professional Counselor
- San Leandro, CA
National Provider Identifier
1821169392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC725
- Practice address
- 15942 Foothill Blvd
San Leandro, CA 94578-2102 - Phone
- (510) 777-5300
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC725 | CA | |
| Professional Counselor | 101YP2500X | LPCC725 | CA | Primary |
Addresses
Primary practice location
15942 Foothill Blvd
San Leandro, CA 94578-2102
Mailing address
6215 Crown Ave
Oakland, CA 94611-2011
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC725 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1821169392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6215 CROWN AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946112011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15942 FOOTHILL BLVD",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782102",
"telephone_number": "510-777-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDEAUX",
"first_name": "CHRISTOPHER",
"middle_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LPCC725",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPCC725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.