LAURIE GOTTLIEB — NPI 1619852449 (Licensed & Credentialed Health & Wellness Coach in FAIRFAX, CA)

CMS-1500 Box 24J / 33a • NPI

1619852449

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171400000X

Licensed & Credentialed Health & Wellness Coach

Box 32 Service Location & ZIP+4

85 BOLINAS RD STE 5, FAIRFAX, CA, 94930-1626

✓ 9-Digit EDI 837 ZIP+4 (94930-1626)

Practice Phone & Referral Fax

(415) 760-6108

Fax: (888) 226-7020

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1619852449 (LAURIE GOTTLIEB) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1619852449` (NPI-1 Individual Practitioner)
Provider / Legal Name	LAURIE GOTTLIEB
Plain-English Specialty	Licensed & Credentialed Health & Wellness Coach NUCC Code: `171400000X` (Health & Wellness Coach)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	85 BOLINAS RD STE 5, FAIRFAX, CA, 94930-1626
Practice Telephone / Fax	Tel: (415) 760-6108 \| Fax: (888) 226-7020
Administrative Mailing Address	159 W OAK KNOLL DR, SAN ANSELMO, CA, 94960-1175
Enumeration & Last Sync	Enumerated: 2025-08-11 \| CMS Record Updated: 2025-08-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

85 BOLINAS RD STE 5, FAIRFAX, CA, 94930-1626

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Plain-English Taxonomy & CMS Crosswalk (171400000X)

What Does Taxonomy Code 171400000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171400000X translates to:
"Licensed & Credentialed Health & Wellness Coach"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Health & Wellness Coach for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LAURIE GOTTLIEB)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`133N00000X` — Nutritionist Plain English: Licensed & Credentialed Nutritionist	State: CA \| License: `Verified` \| Primary: Secondary
`171400000X` — Health & Wellness Coach Plain English: Licensed & Credentialed Health & Wellness Coach	State: CA \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LAURIE GOTTLIEB (NPI #1619852449)