Active NPI
Marta Elena Reynoso, LCSW
- Clinical Social Worker
- Hayward, CA
National Provider Identifier
1003203944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28394
- Practice address
- 409 Jackson St
Suite 200
Hayward, CA 94544-1530 - Phone
- (510) 891-5650
- NPI assigned
- Apr 17, 2015
- 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 | 28394 | CA | Primary |
Addresses
Primary practice location
409 Jackson St
Suite 200
Hayward, CA 94544-1530
Mailing address
954 Helen Ave
San Leandro, CA 94577-2128
Phone (510) 499-8944
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28394 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429228800000",
"number": "1003203944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "954 HELEN AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945772128",
"telephone_number": "510-499-8944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 JACKSON ST",
"address_2": "SUITE 200",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945441530",
"telephone_number": "510-891-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOSO",
"first_name": "MARTA",
"middle_name": "ELENA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-17",
"last_updated": "2015-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.