Active NPI
Axel Zijderveld
- Mental Health Counselor
- Lucerne, CA
National Provider Identifier
1881286565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 6302 Thirteenth Ave
Lucerne, CA 95458 - Phone
- (707) 274-9101
- NPI assigned
- Feb 4, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
6302 Thirteenth Ave
Lucerne, CA 95458
Mailing address
PO Box 1024
Lucerne, CA 95458-1024
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NOT-APPLICABLE |
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": "1612396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1881286565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1024",
"city": "LUCERNE",
"state": "CA",
"postal_code": "954581024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6302 THIRTEENTH AVE",
"city": "LUCERNE",
"state": "CA",
"postal_code": "95458",
"telephone_number": "707-274-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIJDERVELD",
"first_name": "AXEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-04",
"last_updated": "2021-02-04",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NOT-APPLICABLE",
"affiliation": "N",
"address_1": "6302 THIRTEENTH AVE",
"city": "LUCERNE",
"state": "CA",
"country_code": "US",
"postal_code": "95458",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lucerne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.