Individual provider Active NPI

Patrick Charles Kowalski, LCSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1003133810
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28548 Issued in CA
Practice address
170 9TH St
San Francisco, CA 94103-2603
Phone
(415) 777-0333
Fax
(415) 869-4042
NPI assigned
May 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-07166 NM
Clinical Social Worker 1041C0700X 28548 CA Primary

Addresses

Primary practice location

170 9TH St
San Francisco, CA 94103-2603

Mailing address

170 9TH St
San Francisco, CA 94103-2603
Phone (415) 777-0333

Other practice location 1

1519 Bonito Rd SW
Albuquerque, NM 87105-4610
Phone (505) 480-9423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I-07166NMMDClinical Social Worker
28548CAMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1003133810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 9TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032603",
            "telephone_number": "415-777-0333",
            "fax_number": "415-869-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 9TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032603",
            "telephone_number": "415-777-0333",
            "fax_number": "415-869-4042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 Bonito Rd SW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871054610",
            "country_code": "US",
            "telephone_number": "505-480-9423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "PATRICK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-07166",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.