NPIMap

Organization Active NPI

Genesis House

  • Addiction (Substance Use Disorder) Counselor
  • Vallejo, CA
National Provider Identifier
1841954856
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
GENESIS HOUSE
Practice address
1149 Warren Ave
Vallejo, CA 94591-7512
Phone
(707) 552-5295
NPI assigned
Oct 26, 2021
Last updated
Nov 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Authorized official

Name
Kester McDonald
Title
Executive Director
Phone
(707) 552-5295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

1149 Warren Ave
Vallejo, CA 94591-7512

Mailing address

1149 Warren Ave
Vallejo, CA 94591-7512
Phone (707) 552-5295

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppouvoir@genesis-house.com Health Information Exchange (HIE) Genesis House

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: ppouvoir@genesis-house.com

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1841954856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 WARREN AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917512",
            "telephone_number": "707-552-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 WARREN AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917512",
            "telephone_number": "707-552-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "KESTER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-552-5295"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppouvoir@genesis-house.com",
            "affiliation": "Y",
            "affiliationName": "Genesis House",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1149 Warren Ave",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945917512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.