NPIMap

Individual provider Active NPI

Erica Kellenbach, MSW

  • Clinical Social Worker
  • San Leandro, CA
National Provider Identifier
1215007802
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 25257 Issued in CA
Practice address
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone
(510) 772-8067
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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 LCS 25257 CA Primary

Addresses

Primary practice location

2275 Arlington Dr
San Leandro, CA 94578-1132

Mailing address

PO Box 5205
Whittier, CA 90607-5205

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
LCS 25257CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Center Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients
Rocketship Education Wisconsin Inc. Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1215007802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5205",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906075205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 ARLINGTON DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781132",
            "telephone_number": "510-772-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLENBACH",
        "first_name": "ERICA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 25257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.