Individual provider Active NPI

Marsha L Gubser, LCSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1013389915
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 76445 Issued in CA
Practice address
3451 E 12TH St
Oakland, CA 94601-3463
Phone
(925) 363-2005
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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 LCSW 76445 CA Primary

Addresses

Primary practice location

3451 E 12TH St
Oakland, CA 94601-3463

Mailing address

1766 Casa Grande St
Benicia, CA 94510-2336
Phone (707) 297-6210

Other names 1

  • Marsha L Henry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170606002560 CA Order and Referring Only - Clinical Social Worker 1951678317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 76445CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza, Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1013389915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1766 CASA GRANDE ST",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945102336",
            "telephone_number": "707-297-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013463",
            "telephone_number": "925-363-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBSER",
        "first_name": "MARSHA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 76445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARSHA",
            "last_name": "HENRY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.