Active NPI
Ira Kaufman, LCSW
- Social Worker
- Santa Rosa, CA
National Provider Identifier
1104988534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCS17902
- Practice address
- 401 Bicentennial Drive
Santa Rosa, CA 95404 - Phone
- (707) 571-4015
- Fax
- (707) 571-3799
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LCS17902 | CA | Primary |
Addresses
Primary practice location
401 Bicentennial Drive
Santa Rosa, CA 95404
Mailing address
401 Bicentennial Drive
Santa Rosa, CA 95404
Phone (707) 571-4015
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 |
|---|---|---|---|
| LCS17902 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1104988534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 BICENTENNIAL DRIVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "95404",
"telephone_number": "707-571-4015",
"fax_number": "707-571-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BICENTENNIAL DRIVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "95404",
"telephone_number": "707-571-4015",
"fax_number": "707-571-3799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "IRA",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCS17902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.