Active NPI
Andrea Irvine, LCSW
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1083225734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW28956
- Practice address
- 2425 Samaritan Dr
San Jose, CA 95124-3908 - Phone
- (408) 559-2011
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW28956 | CA | Primary |
Addresses
Primary practice location
2425 Samaritan Dr
San Jose, CA 95124-3908
Mailing address
2425 Samaritan Dr
San Jose, CA 95124-3908
Phone (408) 483-9388
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | andrea.irvine@hcahealthcare.com | Direct | HCA Good Samaritan Hospital |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW28956 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Clinical | Current | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 1
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": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1083225734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 SAMARITAN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951243908",
"telephone_number": "408-483-9388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 SAMARITAN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951243908",
"telephone_number": "408-559-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVINE",
"first_name": "ANDREA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW28956",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "andrea.irvine@hcahealthcare.com",
"affiliation": "Y",
"affiliationName": "HCA Good Samaritan Hospital",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2425 Samaritan Dr",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "951243997",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 8, 2021; 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.