Kenneth J Deaver, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS16585 Issued in CA

Practice address

15951 Los Gatos Blvd Ste 18
Los Gatos, CA 95032-3488

Phone

(408) 358-9596

Fax

(408) 358-9596

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053460733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LOS GATOS BLVD STE 18",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323488",
            "telephone_number": "408-358-9596",
            "fax_number": "408-358-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LOS GATOS BLVD STE 18",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323488",
            "telephone_number": "408-358-9596",
            "fax_number": "408-358-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAVER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa De la Torre, D.C.
• Nina De Simone
• Margaret Grace De Villiers, M.D.
• Melissa Dean, LM, CPM
• Nancy Dean, MA
• Michael Debaets
• Elizabeth Debruin, D.C.
• Jennifer Louise Decastro, AUD
• Deepa Ramachandran MD
• Mary Donaldson Defigard, MD

• Clinical Social Worker in Los Gatos, CA
• Providers in Los Gatos, 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 Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.