Active NPI
Kim Olenic, MSW, LCSW
- Clinical Social Worker
- San Mateo, CA
National Provider Identifier
1144655440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28855
- Practice address
- 1700 S Amphlett Blvd
Suite 250F
San Mateo, CA 94402-2701 - Phone
- (310) 908-6142
- NPI assigned
- Sep 5, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 28855 | CA | Primary |
Addresses
Primary practice location
1700 S Amphlett Blvd
Suite 250F
San Mateo, CA 94402-2701
Mailing address
840 Hillcrest Blvd
Millbrae, CA 94030-2322
Phone (310) 908-6142
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 |
|---|---|---|---|
| 28855 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413936000000",
"number": "1144655440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 HILLCREST BLVD",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940302322",
"telephone_number": "310-908-6142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S AMPHLETT BLVD",
"address_2": "SUITE 250F",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022701",
"telephone_number": "310-908-6142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLENIC",
"first_name": "KIM",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-05",
"last_updated": "2014-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.