Individual provider Active NPI

Marrianne McBride

  • Social Worker
  • Santa Rosa, CA
National Provider Identifier
1114614807
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
30 Kawana Springs Rd
Santa Rosa, CA 95404-6309
Phone
(707) 525-0143
NPI assigned
Apr 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

30 Kawana Springs Rd
Santa Rosa, CA 95404-6309

Mailing address

30 Kawana Springs Rd
Santa Rosa, CA 95404-6309
Phone (707) 525-0143

Other practice location 1

490 Mendocino Ave
Santa Rosa, CA 95401-8530
Phone (707) 525-0143 ext. 111

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

Practice roles

OrganizationSpecialtyStatusNew patients
Council on Aging Services for Seniors CurrentSince May 14, 2023 Accepting new patients

Locations

30 Kawana Springs Rd
Santa Rosa, CA 95404
Phone (707) 525-0143

Organizations & group practices 1

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": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1114614807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KAWANA SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046309",
            "telephone_number": "707-525-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 KAWANA SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046309",
            "telephone_number": "707-525-0143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 Mendocino Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954018530",
            "country_code": "US",
            "telephone_number": "707-525-0143 x111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "MARRIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "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 Apr 21, 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.