VERICARE OF CALIFORNIA MEDICAL GROUP (NPI# 1528011764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528011764 |
| Entity Type | Organization |
| Organization Name | VERICARE OF CALIFORNIA MEDICAL GROUP |
| Other Organization Name | VERICARE |
| Practice Address |
81 Professional Ctr Pkwy San Rafael CA 94903-2797 |
| Mailing Address |
4715 Viewridge Ave Ste 230 San Diego CA 92123-1680 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8002578715 |
| Mailing Fax Number | 8008161655 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2009-12-21 |
| NPI Deactivation Date | 04/11/2007 |
| NPI Reactivation Date | 2007-08-09 |
| Authorized Official Name | DANIEL R. BUDD (ASSISTANT CORPORATE SECRETARY) |
| Authorized Official Telephone | 8002578715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CC7816 | 01 |
| CA | GPS000150 | 05 |
| Other Name | Type Code |
|---|---|
| VeriCare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114053 | Vericare of California Medical Group | Social Worker | 325 Kempton St, Spring Valley, CA 91977-5810 | 2006-05-23 |
| 1316992829 | Vericare of California Medical Group | Social Worker | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2006-05-23 |
| 1275588790 | Vericare of California Medical Group | Social Worker | 1835 W La Veta Ave, Orange, CA 92868-4132 | 2006-05-23 |
| 1164475299 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-18 |
| 1407047673 | Vericare of California Medical Group | Nurse Practitioner | 3293 N Drinkwater Blvd, Scottsdale, AZ 85251-6405 | 2007-08-05 |
| 1689629198 | Vericare of California Medical Group | Social Worker | 205 Granada St, Camarillo, CA 93010-7715 | 2006-05-23 |
| 1760437271 | Vericare of California Medical Group | Social Worker | 1505 Colby Dr, Glendale, CA 91205-3307 | 2006-05-23 |
| 1194779439 | Vericare of California Medical Group | Social Worker | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2006-05-20 |
| 1104879980 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-19 |
| 1942254644 | Vericare of California Medical Group | Social Worker | 430 Willow St, Alameda, CA 94501-6130 | 2006-05-19 |
| Street Address |
81 PROFESSIONAL CTR PKWY |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-2797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871135665 | Tina M Galordi | Psychologist | 1414 4th St Ste 201, San Rafael, CA 94901-2857 | 2019-10-13 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1134581986 | Stephen Willis | Psychologist | 4460 Redwood Hwy # 16-320, San Rafael, CA 94903-1951 | 2016-03-22 |
| 1720367956 | Albert Wong | Psychologist | 1 H Street, Suite 203, San Rafael, CA 94901 | 2011-08-05 |
| 1932497377 | Jessica Erin Pullins | Psychologist | 1299 4th St Ste 401, San Rafael, CA 94901-3030 | 2011-07-19 |
| 1194031872 | Duy D. Vu | Psychologist | 4460 Redwood Hwy Ste 16-303, San Rafael, CA 94903-1951 | 2010-08-19 |
| 1871826487 | Aninha Esperanza Livingstone | Psychologist | 700 E St San Rafael Ca 94901, Suite 201, San Rafael, CA 94901 | 2009-09-14 |
| 1609012574 | Ruud Vanwijnen | Psychologist | 15 North Ave, 2-a, San Rafael, CA 94903-4823 | 2008-12-26 |
| 1033386768 | Boukje Elisabeth Eerkens | Psychologist | 101 Lucas Valley Rd Ste 269, San Rafael, CA 94903-1761 | 2008-05-12 |
| 1255547154 | Geraldine Alpert | Psychologist | 33 Bungalow Ave, San Rafael, CA 94901-5140 | 2007-05-15 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on VERICARE OF CALIFORNIA MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.