Active NPI
Mary Penn, LCSW
- Clinical Social Worker
- San Francisco, CA
National Provider Identifier
1104253798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 65541
- Practice address
- 564 6TH St
San Francisco, CA 94103-4708 - Phone
- (415) 241-4266
- Fax
- (415) 241-4201
- NPI assigned
- Sep 27, 2013
- 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 | 65541 | CA | Primary |
Addresses
Primary practice location
564 6TH St
San Francisco, CA 94103-4708
Mailing address
564 6TH St
San Francisco, CA 94103-4708
Phone (415) 241-4266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1041000X | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65541 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1104253798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "564 6TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941034708",
"telephone_number": "415-241-4266",
"fax_number": "415-241-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "564 6TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941034708",
"telephone_number": "415-241-4266",
"fax_number": "415-241-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-27",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "65541",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1041000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.