Individual provider Active NPI

Charlie Hagy Amsden, MSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1063133262
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1555 Parkmoor Ave
San Jose, CA 95128-2407
Phone
(408) 282-0402
NPI assigned
Sep 6, 2022
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1555 Parkmoor Ave
San Jose, CA 95128-2407

Mailing address

PO Box 127
Napa, CA 94559-0127

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Sep 11, 2022 Accepting new patients
Hope Services CurrentSince Sep 11, 2022 Accepting new patients

Locations

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

Organizations & group practices 2

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1063133262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945590127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 PARKMOOR AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282407",
            "telephone_number": "408-282-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSDEN",
        "first_name": "CHARLIE",
        "middle_name": "HAGY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2022-09-06",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Jun 14, 2024; 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.