Individual provider Active NPI

Bernedette Collins

  • Clinical Social Worker
  • Atascadero, CA
National Provider Identifier
1093189656
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94535 Issued in CA
Practice address
10333 El Camino Real
Atascadero, CA 93422-5808
Phone
(805) 468-2705
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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 94535 CA Primary

Addresses

Primary practice location

10333 El Camino Real
Atascadero, CA 93422-5808

Mailing address

PO Box 1109
Atascadero, CA 93423-1109
Phone (805) 392-3966

Other practice location 1

2975 McMillan Ave Ste 164
San Luis Obispo, CA 93401-6768
Phone (805) 439-4890

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
I20251210003693 CA Practitioner - Clinical Social Worker 0446744098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140
Phone (323) 968-6182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
94535CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Dec 1, 2025 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Interoperability endpoints

  • Direct secure messaging: bernedettecollins@tdh.allscriptsdirect.net

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1093189656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934231109",
            "telephone_number": "805-392-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2975 McMillan Ave Ste 164",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934016768",
            "country_code": "US",
            "telephone_number": "805-439-4890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BERNEDETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.