Elizabeth Anne Payne

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

9243 Issued in CA

Practice address

2804 Camino Dos Rios Ste 206
Thousand Oaks, CA 91320-1175

Phone

(617) 379-0496

NPI assigned

Apr 27, 2018

Reactivated

Mar 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thriveworks Clinical - California PC

  • Mental Health Counselor
  • Thousand Oaks, CA
  • NPI 1801481395
  Medicare reassignment NPD

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1972091627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 RIO HATO CT",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102365",
            "telephone_number": "617-379-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 CAMINO DOS RIOS STE 206",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913201175",
            "telephone_number": "617-379-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "deactivation_date": "2020-02-03",
        "reactivation_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012129",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "9243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Paul
• Sergey Pavlov
• Paxxon Healthcare Services LLC
• Jillian Virginia Payne-Friedick, PA-C
• Darren Payne, D.P.M.
• Raymond Lee Payton
• Pediatric Surgery Solutions Inc
• Nazila Pedram
• Megan Peek Monteen, PHARMD
• Pejman Badiei Medical Corp.

• Professional Counselor in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.