Active NPI
Wanda Jo Cloud, CAS
- Addiction (Substance Use Disorder) Counselor
- Eureka, CA
National Provider Identifier
1891118832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 03-086159
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 268-2990
- NPI assigned
- Jan 28, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 03-086159 | CA | Primary |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
2485 Matthew Cir
Eureka, CA 95503-7317
Phone (530) 368-5427
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03-086159 | Other | CA | BOARD FOR CERTIFICATION OF ADDICTION SPECIALIST -CAARR |
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 |
|---|---|---|---|
| 03-086159 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1891118832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2485 MATTHEW CIR",
"city": "EUREKA",
"state": "CA",
"postal_code": "955037317",
"telephone_number": "530-368-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014413",
"telephone_number": "707-268-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUD",
"first_name": "WANDA",
"middle_name": "JO",
"credential": "CAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-28",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "03-086159",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD FOR CERTIFICATION OF ADDICTION SPECIALIST -CAARR",
"identifier": "03-086159",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.