Active NPI
Nicholas Stavrides, CADC
- Addiction (Substance Use Disorder) Counselor
- Campbell, CA
National Provider Identifier
1962181156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CI37041222
- Practice address
- 910 Campisi Way
Campbell, CA 95008-2340 - Phone
- (408) 462-0794
- NPI assigned
- Jul 14, 2023
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CI37041222 | CA | Primary |
Addresses
Primary practice location
910 Campisi Way
Campbell, CA 95008-2340
Mailing address
910 Campisi Way
Campbell, CA 95008-2340
Phone (917) 325-4913
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 |
|---|---|---|---|
| CI37041222 | 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": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1962181156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 CAMPISI WAY",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082340",
"telephone_number": "917-325-4913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 CAMPISI WAY",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082340",
"telephone_number": "408-462-0794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVRIDES",
"first_name": "NICHOLAS",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CI37041222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.