Individual provider Active NPI

Wendy D. Vazquez, MSW

  • Social Worker
  • Colusa, CA
National Provider Identifier
1023773546
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
162 E Carson St Ste a
Colusa, CA 95932-2880
Phone
(530) 458-0520
Fax
(530) 458-7751
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 101001 CA
Social Worker 104100000X Primary

Addresses

Primary practice location

162 E Carson St Ste a
Colusa, CA 95932-2880

Mailing address

162 E Carson St Ste a
Colusa, CA 95932-2880
Phone (530) 458-0520

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
I20250225003011 CA Practitioner - Clinical Social Worker 2769902477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ColusaGroup PAC ID 3173656402, 8 clinicians

Practice addresses (Care Compare)

162 E Carson St
Colusa, CA 95932-2880
Phone (530) 458-0520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
128264CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Colusa CurrentSince Jan 1, 2025 Accepting new patients

Locations

162 E Carson St
Ste A
Colusa, CA 95932
Phone (530) 458-0520

162 E Carson St
Colusa, CA 95932
Phone (530) 458-0520

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/colusar-7905f953

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1023773546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 E CARSON ST STE A",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322880",
            "telephone_number": "530-458-0520",
            "fax_number": "530-458-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 E CARSON ST STE A",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322880",
            "telephone_number": "530-458-0520",
            "fax_number": "530-458-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "WENDY",
        "middle_name": "D.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "101001",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colusa, CA

Sources for this page

Verify at the official NPI Registry.