Individual provider Active NPI

Ana R Tafolla Rios

  • Clinical Social Worker
  • Novato, CA
National Provider Identifier
1114575784
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125836 Issued in CA
Practice address
6090 Redwood Blvd
Novato, CA 94945-4569
Phone
(415) 448-1500
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW104043 CA
Clinical Social Worker 1041C0700X 125836 CA Primary

Addresses

Primary practice location

6090 Redwood Blvd
Novato, CA 94945-4569

Mailing address

6090 Redwood Blvd
Novato, CA 94945-4569
Phone (415) 448-1500

Other identifiers 1

IdentifierTypeStateIssuer
228106OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES

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

LicenseStateTypeSpecialty
ASW104043CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centella Licensed Clinical Social Worker Inc Clinical Current Accepting new patients
Instituto Familiar de la Raza PastSince Sep 1, 2019 Accepting new patients

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1114575784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6090 REDWOOD BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454569",
            "telephone_number": "415-448-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6090 REDWOOD BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454569",
            "telephone_number": "415-448-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAFOLLA RIOS",
        "first_name": "ANA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW104043",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "228106",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.