Individual provider Active NPI

Andrew Demers

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1992166466
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114170 Issued in CA
Practice address
522 Grand Ave
Oakland, CA 94610-3515
Phone
(510) 208-1870
NPI assigned
Mar 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 10353 AZ
Marriage & Family Therapist 106H00000X 114170 CA Primary
Marriage & Family Therapist 106H00000X LF 60645169 WA

Addresses

Primary practice location

522 Grand Ave
Oakland, CA 94610-3515

Mailing address

522 Grand Ave
Oakland, CA 94610-3515
Phone (510) 208-1870

Other practice location 1

2209 E 32nd St
Tacoma, WA 98404-4922
Phone (253) 593-0247

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

LicenseStateTypeSpecialty
114170CAMDMarriage & Family Therapist
LF 60645169WAMDMarriage & Family Therapist
10353AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Indian Child Resource Center CurrentSince May 28, 2023 Accepting new patients

Locations

522 Grand Ave
Oakland, CA 94610
Phone (510) 208-1870

Organizations & group practices 1

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1992166466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103515",
            "telephone_number": "510-208-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103515",
            "telephone_number": "510-208-1870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 E 32nd St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984044922",
            "country_code": "US",
            "telephone_number": "253-593-0247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMERS",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "10353",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114170",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF 60645169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.