Active NPI
Donna L Bickham, ACSW
- Clinical Social Worker
- Stockton, CA
National Provider Identifier
1003099177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18102
- Practice address
- 1212 N California St
Stockton, CA 95202-1552 - Phone
- (209) 953-7313
- Fax
- (209) 468-9633
- NPI assigned
- Dec 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18102 | CA | Primary |
Addresses
Primary practice location
1212 N California St
Stockton, CA 95202-1552
Mailing address
1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8482
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18102 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Joaquin Behavioral Health Services | Clinical | Current | Accepting new patients |
Locations
1212 N California St
Stockton, CA 95202
Phone (209) 468-8660
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Stockton, CA
- NPI 1215028931
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1003099177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021552",
"telephone_number": "209-468-8482",
"fax_number": "209-468-8485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021552",
"telephone_number": "209-953-7313",
"fax_number": "209-468-9633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BICKHAM",
"first_name": "DONNA",
"middle_name": "L",
"credential": "ACSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-12",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "18102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.