Blanca Isela Tabares, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27775 Issued in CA

Practice address

5671 Santa Teresa Blvd
Suite105
San Jose, CA 95123-6512

Phone

(408) 284-2280

Fax

(408) 754-0450

NPI assigned

Jun 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Quest Health Management Psychological Corporation

  • Community/Behavioral Health Agency
  • Chino, CA
  • NPI 1245791490
  Medicare reassignment NPD
• Daybreak Medical PC

  • Adolescent and Children Mental Health Clinic/Center
  • San Francisco, CA
  • NPI 1417526716

  Clinical

  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1043470354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 SANTA TERESA BLVD",
            "address_2": "SUITE105",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951236512",
            "telephone_number": "408-284-2280",
            "fax_number": "408-754-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 SANTA TERESA BLVD",
            "address_2": "SUITE105",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951236512",
            "telephone_number": "408-284-2280",
            "fax_number": "408-754-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABARES",
        "first_name": "BLANCA",
        "middle_name": "ISELA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ZZZ00543Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mae Pearl Ta, AMFT, APCC
• Thanh D. Ta, PHARM.D.
• Theresa Ta, DDS
• Vuong Ta
• Vitani F Taamu
• Sarah Tabbarah, PH.D
• Antonio Tabboga
• Cristina Atienza Tabboga
• Shannen Tabboga
• Zildjian Tabboga

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.