Individual provider Active NPI

Adelina Alvarez Johnson

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1164621389
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21396 Issued in CA
Practice address
150 W Hedding St
Custody Mental Health
San Jose, CA 95110-1706
Phone
(408) 808-5221
NPI assigned
Jul 17, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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 LCS21396 CA Primary

Addresses

Primary practice location

150 W Hedding St
Custody Mental Health
San Jose, CA 95110-1706

Mailing address

150 W Hedding St
Custody Mental Health
San Jose, CA 95110-1706
Phone (408) 808-5221

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS21396CAMDClinical Social Worker
21396CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1164621389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W HEDDING ST",
            "address_2": "CUSTODY MENTAL HEALTH",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101706",
            "telephone_number": "408-808-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HEDDING ST",
            "address_2": "CUSTODY MENTAL HEALTH",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101706",
            "telephone_number": "408-808-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ JOHNSON",
        "first_name": "ADELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.