Active NPI
Lisa De Geneste, LCSW
- Social Worker
- Oakland, CA
National Provider Identifier
1124285705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 25284
- Practice address
- 400 29TH St Ste 405
Oakland, CA 94609-3549 - Phone
- (917) 566-5628
- NPI assigned
- May 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 14531 | FL | |
| Clinical Social Worker | 1041C0700X | 043132 | NY | |
| Social Worker | 104100000X | 25284 | CA | Primary |
Addresses
Primary practice location
400 29TH St Ste 405
Oakland, CA 94609-3549
Mailing address
400 29TH St Ste 405
Oakland, CA 94609-3549
Phone (917) 566-5628
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14531 | FL | MD | General Practice Dentistry |
| 043132 | NY | MD | Physical Therapist |
| 25284 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543449600000",
"number": "1124285705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 29TH ST STE 405",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093549",
"telephone_number": "917-566-5628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 29TH ST STE 405",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093549",
"telephone_number": "917-566-5628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE GENESTE",
"first_name": "LISA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-21",
"last_updated": "2018-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "14531",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "043132",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "25284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.