KRISTIN ANDERSEN
NPI 1083277578
Counselor - Mental Health in San Rafael, CA

Q: What is Kristin Andersen's NPI number?

The NPI number for Kristin Andersen is 1083277578. It was assigned to this individual provider in the NPPES registry on April 19, 2019.

Q: What is Kristin Andersen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Kristin Andersen enrolled in Medicare?

No. Kristin Andersen has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kristin Andersen was last updated on November 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 19, 2019Opted out of Medicare · through Jan 1, 2028

1330 LINCOLN AVE STE 201, SAN RAFAEL, CA 94901(415) 459-5999 Get Directions Write a Review

NPPES record last updated: November 9, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 9, 2021, Nov 17, 2020, Apr 19, 2019 (3 updates tracked since 2019).

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About Kristin Andersen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTIN ANDERSEN (NPI 1083277578) is an individual mental health provider in San Rafael, California and active in the NPI registry since April 2019. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1083277578

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKRISTIN ANDERSEN

Location Address1330 LINCOLN AVE STE 201San Rafael, CA 94901-2142

Mailing AddressPo Box 6102San Rafael, CA 94903-0102 · (415) 534-0055

Phone(415) 459-5999

Sole ProprietorNo

Enumeration DateApril 19, 2019

Last NPPES UpdateNovember 9, 20213 updates tracked since enumeration

NPPES CertifiedNovember 9, 2021

✔ NPI 1083277578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

1330 LINCOLN AVE STE 201, San Rafael, CA 94901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kristin Andersen has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA SANANES

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