Individual provider Active NPI

Elizabeth Creighton O'Brien

  • Clinical Social Worker
  • Inverness, CA
National Provider Identifier
1205145497
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27429 Issued in CA
Practice address
259 Laurel Street
Inverness, CA 94937
Phone
(415) 870-4660
Fax
(000) 555-5555
NPI assigned
Oct 5, 2010
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27429 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

259 Laurel Street
Inverness, CA 94937

Mailing address

PO Box 96
Point Reyes Station, CA 94956-0096
Phone (415) 444-6715

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
27429CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1205145497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560096",
            "telephone_number": "415-444-6715",
            "fax_number": "000-555-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 LAUREL STREET",
            "city": "INVERNESS",
            "state": "CA",
            "postal_code": "94937",
            "telephone_number": "415-870-4660",
            "fax_number": "000-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ELIZABETH",
        "middle_name": "CREIGHTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27429",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.