Individual provider Active NPI

Amber Rosemarie Anderson, ACSW

  • Clinical Social Worker
  • San Mateo, CA
National Provider Identifier
1194126599
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3701 Hacienda St
San Mateo, CA 94403-4366
Phone
(650) 204-9695
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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 Primary

Addresses

Primary practice location

3701 Hacienda St
San Mateo, CA 94403-4366

Mailing address

3701 Hacienda St
San Mateo, CA 94403-4366
Phone (650) 204-9695

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

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1194126599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 HACIENDA ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034366",
            "telephone_number": "650-204-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 HACIENDA ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034366",
            "telephone_number": "650-204-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMBER",
        "middle_name": "ROSEMARIE",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Mar 11, 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.

Verify at the official NPI Registry.