NPIMap

Organization Active NPI

Los Gatos Therapy Center

Doing business as LGTC Group

  • Adolescent and Children Mental Health Clinic/Center
  • Burlingame, CA
National Provider Identifier
1942893953
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
LOS GATOS THERAPY CENTER
Doing business as
LGTC Group
Practice address
1575 Old Bayshore Hwy Ste 205
Burlingame, CA 94010-1613
Phone
(669) 254-4852
Fax
(408) 796-1558
NPI assigned
Feb 19, 2021
Organization subpart
Yes
Parent organization
LOS GATOS THERAPY CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Eugene Tilman
Title
Director of Operation
Phone
(800) 913-2615

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1575 Old Bayshore Hwy Ste 205
Burlingame, CA 94010-1613

Mailing address

2542 S Bascom Ave Ste 110
Campbell, CA 95008-5541
Phone (669) 254-4852

Other names 1

  • LGTC GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Los Gatos Therapy Center5 organizations share this tax ID, including this one
Part of
Los Gatos Therapy Center

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1575 Old Bayshore Hwy
Ste 205
Burlingame, CA 94010
Phone (669) 200-2709

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1942893953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 S BASCOM AVE STE 110",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085541",
            "telephone_number": "669-254-4852",
            "fax_number": "408-796-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 OLD BAYSHORE HWY STE 205",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101613",
            "telephone_number": "669-254-4852",
            "fax_number": "408-796-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS GATOS THERAPY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOS GATOS THERAPY CENTER",
        "enumeration_date": "2021-02-19",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "TILMAN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "800-913-2615"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LGTC GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.