Individual provider Active NPI

Tiffany Leanne Zaragoza, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1053083832
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104107 Issued in CA
Practice address
6920 Santa Teresa Blvd Ste 101
San Jose, CA 95119-1344
Phone
(510) 364-9717
NPI assigned
Sep 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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 104107 CA Primary

Addresses

Primary practice location

6920 Santa Teresa Blvd Ste 101
San Jose, CA 95119-1344

Mailing address

15329 Inverness St
San Leandro, CA 94579-2015
Phone (510) 364-9717

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

LicenseStateTypeSpecialty
104107CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1053083832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15329 INVERNESS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945792015",
            "telephone_number": "510-364-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 SANTA TERESA BLVD STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191344",
            "telephone_number": "510-364-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARAGOZA",
        "first_name": "TIFFANY",
        "middle_name": "LEANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.