Active NPI
Andrew King Durham
- Clinical Social Worker
- Seaside, CA
National Provider Identifier
1033528484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- Q1-0001234
- Practice address
- 3401 Engineer LN
Seaside, CA 93955-7200 - Phone
- (831) 883-3800
- Fax
- (831) 883-3813
- NPI assigned
- Aug 11, 2014
- Sex
- Male
- 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 | Q1-0001234 | DE | Primary |
Addresses
Primary practice location
3401 Engineer LN
Seaside, CA 93955-7200
Mailing address
3401 Engineer LN
Seaside, CA 93955-7200
Phone (831) 883-3800
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 |
|---|---|---|---|
| Q1-0001234 | DE | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1033528484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 ENGINEER LN",
"city": "SEASIDE",
"state": "CA",
"postal_code": "939557200",
"telephone_number": "831-883-3800",
"fax_number": "831-883-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 ENGINEER LN",
"city": "SEASIDE",
"state": "CA",
"postal_code": "939557200",
"telephone_number": "831-883-3800",
"fax_number": "831-883-3813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "ANDREW",
"middle_name": "KING",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-11",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DE",
"license": "Q1-0001234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seaside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.