Individual provider Active NPI

Viju Veliyath Thomas, LCSW

  • Clinical Social Worker
  • Fremont, CA
National Provider Identifier
1063602282
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 18844 Issued in CA
Practice address
39155 Liberty St
Suite G710
Fremont, CA 94538-1513
Phone
(510) 795-2434
NPI assigned
Jul 25, 2007
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 LCS 18844 CA Primary

Addresses

Primary practice location

39155 Liberty St
Suite G710
Fremont, CA 94538-1513

Mailing address

39155 Liberty St
Suite G710
Fremont, CA 94538-1513
Phone (510) 795-2434

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101209000454 CA Practitioner - Clinical Social Worker 0749477206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 18844CAMDClinical Social Worker
18844CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda County CurrentSince Jul 8, 2025 Accepting new patients
Alameda County Current Accepting new patients

Locations

39155 Liberty St
Ste G710
Fremont, CA 94538
Phone (510) 795-2434

409 Jackson St
Ste 100
Hayward, CA 94544
Phone (510) 383-5103

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1063602282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39155 LIBERTY ST",
            "address_2": "SUITE G710",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381513",
            "telephone_number": "510-795-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39155 LIBERTY ST",
            "address_2": "SUITE G710",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381513",
            "telephone_number": "510-795-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "VIJU",
        "middle_name": "VELIYATH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 18844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.