Individual provider Active NPI

Denita Elena Packard, LCSW

  • Clinical Social Worker
  • Nevada City, CA
National Provider Identifier
1104525633
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117631 Issued in CA
Practice address
825 Zion St
Nevada City, CA 95959-2922
Phone
(530) 648-0480
NPI assigned
Feb 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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 117631 CA Primary

Addresses

Primary practice location

825 Zion St
Nevada City, CA 95959-2922

Mailing address

PO Box 3498
Grass Valley, CA 95945-3498
Phone (415) 747-5180

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
I20260605000509 CA Practitioner - Clinical Social Worker 6800367392 Practice locations: Nevada City, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

825 Zion St
Nevada City, CA 95959-2922
Phone (530) 648-0480

PO Box
Suite 3498
Grass Valley, CA 95945

PO Box
Suite 3498
Grass Valley, CA 95945-3461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117631CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1104525633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3498",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959453498",
            "telephone_number": "415-747-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 ZION ST",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592922",
            "telephone_number": "530-648-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "DENITA",
        "middle_name": "ELENA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "117631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada City, CA

Sources for this page

Verify at the official NPI Registry.