Individual provider Active NPI

Beatriz Behrens, LCSW 121322

  • Social Worker
  • Santa Rosa, CA
National Provider Identifier
1205271798
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
121322 Issued in CA
Practice address
1360 N Dutton Ave Ste C
Santa Rosa, CA 95401-4668
Phone
(707) 889-7901
Fax
(707) 565-1110
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 121322 CA
Social Worker 104100000X 121322 CA Primary

Addresses

Primary practice location

1360 N Dutton Ave Ste C
Santa Rosa, CA 95401-4668

Mailing address

1360 N Dutton Ave Ste C
Santa Rosa, CA 95401-4668
Phone (707) 889-7901

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
121322CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1205271798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 N DUTTON AVE STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014668",
            "telephone_number": "707-889-7901",
            "fax_number": "707-565-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N DUTTON AVE STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014668",
            "telephone_number": "707-889-7901",
            "fax_number": "707-565-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "BEATRIZ",
        "credential": "LCSW 121322",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121322",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "121322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.