Individual provider Active NPI

Bruce Anderson, MD

  • Psychiatry Physician
  • Saint Helena, CA
National Provider Identifier
1942276324
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A21633 Issued in CA
Practice address
6 Woodland Rd
Suite 302
Saint Helena, CA 94574-9501
Phone
(707) 963-8802
Fax
(707) 963-6328
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A21633 CA Primary

Addresses

Primary practice location

6 Woodland Rd
Suite 302
Saint Helena, CA 94574-9501

Mailing address

6 Woodland Rd
Suite 302
Saint Helena, CA 94574-9501
Phone (707) 963-8802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081224000071 CA Practitioner - Psychiatry 1254230238 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A21633CAMDPsychiatry Physician
21633CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Psychiatry Group, P.C Psychiatry CurrentSince Jun 13, 2010 Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 1, 2011 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 1, 2011 Accepting new patients

Locations

913 Washington St
Calistoga, CA 94515
Phone (707) 942-0844

15230 Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-4500

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

821 Saint Helena Hwy S
#208
Saint Helena, CA 94574

6 Woodland Rd
Ste 302
Saint Helena, CA 94574
Phone (707) 963-8802

999 Adams St
Ste 106
Saint Helena, CA 94574
Phone (707) 963-4997

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1942276324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "address_2": "SUITE 302",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749501",
            "telephone_number": "707-963-8802",
            "fax_number": "707-963-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "address_2": "SUITE 302",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749501",
            "telephone_number": "707-963-8802",
            "fax_number": "707-963-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A21633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.