Active NPI
Brooke Michele Erickson, MSW
- Social Worker
- Modesto, CA
National Provider Identifier
1003693433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 13487659-3502
- Practice address
- 118 Palm Ave
Modesto, CA 95350-5420 - Phone
- (209) 764-0124
- NPI assigned
- Sep 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW115113 | CA | |
| Social Worker | 104100000X | 13487659-3502 | UT | Primary |
Addresses
Primary practice location
118 Palm Ave
Modesto, CA 95350-5420
Mailing address
118 Palm Ave
Modesto, CA 95350-5420
Phone (209) 764-0124
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW115113 | CA | MD | Social Worker |
| 13487659-3502 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1003693433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 PALM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505420",
"telephone_number": "209-764-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 PALM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505420",
"telephone_number": "209-764-0124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "BROOKE",
"middle_name": "MICHELE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW115113",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "13487659-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.