Sydney Louise Tai

Primary specialty

Social WorkerTaxonomy code 104100000X

License

112863 Issued in CA

Practice address

160 E Virginia St
San Jose, CA 95112-5857

Phone

(408) 287-6200

Fax

(408) 271-3909

NPI assigned

Nov 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Syd Lou Wahlstrom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Gardner Family Health Network, Inc.

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1699841528
  NPD

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1104338805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125857",
            "telephone_number": "408-287-6200",
            "fax_number": "408-998-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125857",
            "telephone_number": "408-287-6200",
            "fax_number": "408-271-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "SYDNEY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112863",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "112863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYD",
            "last_name": "WAHLSTROM",
            "middle_name": "LOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitra N/a Taheri
• Shahram Taheri, DDS, MS
• Siavash Taheri, RN
• Victoria Shireen Tahmassebi, PA-C
• Phoebe Tai
• Carole Ann Tait-Starnes, M.A.
• Elizabeth Anne Tait
• Avery Takaha
• Albert Yukimasa Takahashi I, PHARMACIST
• Krissiane Irao Takakura, LMFT

• Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.