Georginea L Mackie, INTERN MSW STUDENT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

13585 San Pablo Avenue
1St Floor
San Pablo, CA 94806

Phone

(510) 942-4600

NPI assigned

May 2, 2023

Last updated

Jul 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Contra Costa County

  dba West County Childrens Mental Health Services

  • Adolescent and Children Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1508936188
  NPD

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1225727670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVENUE 1ST FLOOR",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVENUE",
            "address_2": "1ST FLOOR",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806",
            "telephone_number": "510-942-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "GEORGINEA",
        "middle_name": "L",
        "credential": "INTERN MSW STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Luu, LCSW
• Van Bich Ly
• Macias and Crespo Dental Corporation
• Cesar Macias Torres, DDS
• Francisco Javier Macias, DDS
• Mahsa Jaberiansari DDS Inc
• Emilia Bairstow Majersik
• Abid Majid, MD
• Marvelle Tekola Maloney, M.D.
• Chris Mamon

• Student in an Organized Health Care Education/Training Program in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.