Active NPI
Laila Ansari
- Counselor
- San Rafael, CA
National Provider Identifier
1932395704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1401 Los Gamos Dr Ste 240
San Rafael, CA 94903-1835 - Phone
- (415) 457-1925
- NPI assigned
- Sep 14, 2007
- Last updated
- Jul 21, 2022
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
1401 Los Gamos Dr Ste 240
San Rafael, CA 94903-1835
Mailing address
1401 Los Gamos Dr Ste 240
San Rafael, CA 94903-1835
Phone (415) 457-1925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 7, 2023 through Aug 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31204 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1932395704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 LOS GAMOS DR STE 240",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031835",
"telephone_number": "415-457-1925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 LOS GAMOS DR STE 240",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031835",
"telephone_number": "415-457-1925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANSARI",
"first_name": "LAILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.