Active NPI
Vanessa Selene Tinajero, LCSW
- Social Worker
- Sacramento, CA
National Provider Identifier
1164943049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3615 Macorni Ave
Sacramento, CA 95821 - Phone
- (916) 890-3000
- NPI assigned
- Jun 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 96942 | CA | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
3615 Macorni Ave
Sacramento, CA 95821
Mailing address
PO Box 757
West Sacramento, CA 95605-0757
Phone (916) 596-3508
Other practice location 1
1600 California Drive
Vacaville, CA 95687
Phone (916) 596-3508
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 |
|---|---|---|---|
| 96942 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1164943049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 757",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956050757",
"telephone_number": "916-596-3508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 MACORNI AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95821",
"telephone_number": "916-890-3000"
}
],
"practiceLocations": [
{
"address_1": "1600 California Drive",
"address_purpose": "LOCATION",
"city": "Vacaville",
"state": "CA",
"postal_code": "95687",
"country_code": "US",
"telephone_number": "916-596-3508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TINAJERO",
"first_name": "VANESSA",
"middle_name": "SELENE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-30",
"last_updated": "2020-11-06",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "96942",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.