Individual provider Active NPI

Roslyn S Satten, LCSW

  • Clinical Social Worker
  • Fort Bragg, CA
National Provider Identifier
1164582268
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS17657 Issued in CA
Practice address
331 A Redwood Ave
Fort Bragg, CA 95437
Phone
(707) 964-2031
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS17657 CA Primary

Addresses

Primary practice location

331 A Redwood Ave
Fort Bragg, CA 95437

Mailing address

32161 Ellison Way
Fort Bragg, CA 95437
Phone (707) 964-1416

Other names 1

  • Ms. Roslyn S Stalzer Former name

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
I20050203000730 CA Practitioner - Clinical Social Worker 0648221960 Practice locations: Fort Bragg, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

331 E Redwood Ave
Suite a
Fort Bragg, CA 95437-3531
Phone (707) 357-1365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS17657CAMDClinical Social Worker
17657CAMDPrimary Care Clinic/Center

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1164582268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32161 ELLISON WAY",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 A REDWOOD AVE",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTEN",
        "first_name": "ROSLYN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS17657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSLYN",
            "last_name": "STALZER",
            "middle_name": "S",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Bragg, CA

Sources for this page

Verify at the official NPI Registry.