Individual provider Active NPI

Que Phan Vuong, LCSW

  • Clinical Social Worker
  • San Mateo, CA
National Provider Identifier
1124466248
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW99848 Issued in CA
Practice address
1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone
(650) 454-4711
NPI assigned
Jun 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X ASW75320 CA
Mental Health Counselor 101YM0800X ASW75320 CA
Clinical Social Worker 1041C0700X ASW75320 CA
Clinical Social Worker 1041C0700X LCSW99848 CA Primary

Addresses

Primary practice location

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222

Mailing address

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone (650) 454-4711

Other practice location 1

982 Mission St
San Francisco, CA 94103-2911
Phone (415) 597-9334

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
I20230414000494 CA Practitioner - Clinical Social Worker 9830564392 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW75320CAMDCounselor
LCSW99848CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Dec 22, 2022 Accepting new patients
County of San Mateo Current Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Aug 5, 2024 Accepting new patients
San Mateo County Mental Health CurrentSince Dec 22, 2022 Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8650

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1124466248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-454-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-454-4711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032911",
            "country_code": "US",
            "telephone_number": "415-597-9334",
            "fax_number": "415-597-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VUONG",
        "first_name": "QUE PHAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "ASW75320",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW75320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW75320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW99848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.