Active NPI
Abigail Dembo
- Clinical Social Worker
- Berkeley, CA
National Provider Identifier
1013694884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 87500
- Practice address
- 2119 Essex St
Berkeley, CA 94705-1814 - Phone
- (812) 369-3659
- NPI assigned
- Jul 3, 2023
- 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 | 87500 | CA | Primary |
Addresses
Primary practice location
2119 Essex St
Berkeley, CA 94705-1814
Mailing address
2119 Essex St
Berkeley, CA 94705-1814
Phone (812) 369-3659
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 |
|---|---|---|---|
| 87500 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1013694884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 ESSEX ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051814",
"telephone_number": "812-369-3659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2119 ESSEX ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051814",
"telephone_number": "812-369-3659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMBO",
"first_name": "ABIGAIL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "87500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Aug 7, 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.