Active NPI
Mary de Crus Nolan, L.C.S.W.
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1184823809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS17322
- Practice address
- 925 Brockhurst St
Oakland, CA 94608-4222 - Phone
- (510) 923-9600
- Fax
- (510) 923-9606
- NPI assigned
- Jul 12, 2007
- 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 | LCS17322 | CA | Primary |
Addresses
Primary practice location
925 Brockhurst St
Oakland, CA 94608-4222
Mailing address
925 Brockhurst St
Oakland, CA 94608-4222
Phone (510) 923-9600
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 |
|---|---|---|---|
| LCS17322 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1184823809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 BROCKHURST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946084222",
"telephone_number": "510-923-9600",
"fax_number": "510-923-9606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 BROCKHURST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946084222",
"telephone_number": "510-923-9600",
"fax_number": "510-923-9606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "MARY DE CRUS",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-12",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS17322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.