Individual provider Active NPI

Michael E Gammino, CLINCIAL SOCIAL WORK

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1194238683
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16284 Issued in CA
Practice address
3610 Sacramento St
San Francisco, CA 94118-1734
Phone
(415) 931-2684
NPI assigned
Nov 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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 16284 CA Primary

Addresses

Primary practice location

3610 Sacramento St
San Francisco, CA 94118-1734

Mailing address

PO Box 475485
San Francisco, CA 94147-5485
Phone (415) 931-2684

Other identifiers 1

IdentifierTypeStateIssuer
14127040OtherCACAQH ID

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

LicenseStateTypeSpecialty
16284CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1194238683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475485",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941475485",
            "telephone_number": "415-931-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 SACRAMENTO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181734",
            "telephone_number": "415-931-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMINO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CLINCIAL SOCIAL WORK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "16284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14127040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.