Individual provider Active NPI

Patricia Ann Haas, MSW

  • Clinical Social Worker
  • Vallejo, CA
National Provider Identifier
1215090568
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LIC6071 Issued in CA
Practice address
1761 Broadway Suite 100
Kaiser Permanente Vallejo Medical Center Dept of Psycia
Vallejo, CA 94589-2485
Phone
(707) 645-2700
Fax
(707) 645-2181
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 LIC6071 CA Primary

Addresses

Primary practice location

1761 Broadway Suite 100
Kaiser Permanente Vallejo Medical Center Dept of Psycia
Vallejo, CA 94589-2485

Mailing address

564 Willow Court
Benicia, CA 94510-1447
Phone (707) 746-6776

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
LIC6071CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1215090568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 WILLOW COURT",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945101447",
            "telephone_number": "707-746-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BROADWAY SUITE 100",
            "address_2": "KAISER PERMANENTE VALLEJO MEDICAL CENTER DEPT OF PSYCIA",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892485",
            "telephone_number": "707-645-2700",
            "fax_number": "707-645-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LIC6071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.