Active NPI
Stephen Gunnar Wassather, MA
- Mental Health Counselor
- Auburn, CA
National Provider Identifier
1992298269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16640
- Practice address
- 11434 B Avenue
Auburn, CA 95603 - Phone
- (530) 889-7204
- NPI assigned
- Jun 12, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 16640 | CA | Primary |
Addresses
Primary practice location
11434 B Avenue
Auburn, CA 95603
Mailing address
101 Cirby Hills Dr
Roseville, CA 95678-4360
Other practice location 1
101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone (530) 889-7204
Other practice location 2
101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone (916) 787-8800
Other practice location 3
225 37th Ave Fl 3
San Mateo, CA 94403-4324
Phone (650) 573-2501
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1992298269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CIRBY HILLS DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956784360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11434 B AVENUE",
"city": "AUBURN",
"state": "CA",
"postal_code": "95603",
"telephone_number": "530-889-7204"
}
],
"practiceLocations": [
{
"address_1": "101 Cirby Hills Dr",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956784360",
"country_code": "US",
"telephone_number": "530-889-7204",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 Cirby Hills Dr",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956784360",
"country_code": "US",
"telephone_number": "916-787-8800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "225 37th Ave Fl 3",
"address_purpose": "LOCATION",
"city": "San Mateo",
"state": "CA",
"postal_code": "944034324",
"country_code": "US",
"telephone_number": "650-573-2501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WASSATHER",
"first_name": "STEPHEN",
"middle_name": "GUNNAR",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-12",
"last_updated": "2024-06-12",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "16640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.