DESHAUN LAMAR MOOTRY (NPI# 1003466103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003466103 |
| Entity Type | Individual |
| Full Name | DESHAUN LAMAR MOOTRY |
| Practice Address |
1385 N Hamilton Pkwy Novato CA 94949-8276 |
| Practice Telephone | 4153823363 |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1385 N HAMILTON PKWY |
| City | NOVATO |
| State | CA |
| Zip Code | 94949-8276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962649772 | Kelley Smith | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2009-01-15 |
| 1568079887 | Laurel Te Velde | Specialist | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-09-30 |
| 1669087474 | Corina Dorothy Vitale | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-09-09 |
| 1356951826 | Martin Uche | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-08-08 |
| 1578118709 | Sarah Jasmine Bailey | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-08-05 |
| 1023577152 | Megan Latrice Bagby | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-03-18 |
| 1639683733 | Robert Turner Johnson | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2017-11-28 |
| 1952845034 | Deonna Donnyell Jennings | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-12-08 |
| 1982159323 | Bailey Tiura | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-08-15 |
| 1164977500 | Kelsi Mundell | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-08-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365427 | Rebecca Pia Ashkenazy | Counselor | 201 Alameda Del Prado Suite 201, Novato, CA 94949 | 2020-01-15 |
| 1063073583 | Minding Your Body | Clinic/Center | 250 Bel Marin Keys Boulevard, Suite D1, Nevato, CA 94949 | 2019-06-25 |
| 1750743555 | Shivani Vasishta | Physician Assistant | 5800 Nave Dr, Novato, CA 94949 | 2016-03-22 |
| 1780065516 | Sikander Isshak | Pharmacist | 437 Via Del Plano, Novato, CA 94949 | 2015-06-17 |
| 1619224763 | Kerby Ann Gleeson | Social Worker | 1385 North Hamilton Parkway, Novato, CA 94949 | 2012-08-08 |
| 1295094241 | Stacy Anne Rosenblatt | Social Worker | 1385 North Hamilton Prkway, Novato, CA 94949 | 2012-05-11 |
| 1487913505 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 394 Bel Marin Keys Blvd, Suite 4, Novato, CA 94949 | 2012-05-09 |
| 1609181213 | Vincent Gregory Pons | Internal Medicine | 448 Ignacio Blvd, No. 403, Novato, CA 94949 | 2010-08-09 |
| 1811217946 | Prima Medical Foundation | Clinic/Center | 4 Hamilton Landing, Suite 100, Novato, CA 94949 | 2010-06-11 |
| 1770776957 | Lisa Marutani | Registered Nurse | 21 Tamal Vista, 100, Corte Madera, CA 94949 | 2007-08-22 |
| Find all providers in zip 94949 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365427 | Rebecca Pia Ashkenazy | Counselor | 201 Alameda Del Prado Suite 201, Novato, CA 94949 | 2020-01-15 |
| 1346724457 | Leticia Marie Algere | Counselor | 1024 7th St, Novato, CA 94945-2206 | 2018-09-24 |
| 1558969873 | Adeel Ahmad | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2020-10-09 |
| 1669087474 | Corina Dorothy Vitale | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-09-09 |
| 1356951826 | Martin Uche | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-08-08 |
| 1578118709 | Sarah Jasmine Bailey | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-08-05 |
| 1861050205 | Khlood Salah | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2019-05-31 |
| 1649731704 | Rebecca Newton | Counselor | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2019-03-29 |
| 1023577152 | Megan Latrice Bagby | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-03-18 |
| 1649754318 | Suzanne Jessup | Counselor | 1682 Novato Blvd, Novato, CA 94947-7000 | 2018-09-19 |
| Find all providers in NOVATO | ||||
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| 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.