Individual provider Active NPI

Rebecca Wu

  • Clinical Social Worker
  • Berkeley, CA
National Provider Identifier
1003482514
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94939 Issued in CA
Practice address
3017 Telegraph Ave Ste 210
Berkeley, CA 94705-2049
Phone
(510) 926-6677
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 94939 CA Primary

Addresses

Primary practice location

3017 Telegraph Ave Ste 210
Berkeley, CA 94705-2049

Mailing address

75 Lakeshore CT
Richmond, CA 94804-4596

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL URL Direct Foresight Mental Health
Other URL https://www.foresightmentalhealth.com Foresight Mental Health

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
94939CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1003482514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LAKESHORE CT",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948044596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 TELEGRAPH AVE STE 210",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052049",
            "telephone_number": "510-926-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "Y",
            "endpointDescription": "https://www.foresightmentalhealth.com",
            "affiliationName": "Foresight Mental Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3017 Telegraph Ave Ste 210",
            "city": "Berkeley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "947052049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.foresightmentalhealth.com",
            "affiliation": "Y",
            "endpointDescription": "Foresight Mental Health Website",
            "affiliationName": "Foresight Mental Health",
            "address_1": "3017 Telegraph Ave Ste 210",
            "city": "Berkeley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "947052049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.