Individual provider Active NPI

Alexa Tabb, LCSW

  • Clinical Social Worker
  • Berkeley, CA
National Provider Identifier
1235634288
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008095A Issued in IN
Practice address
2375 Shattuck Ave
Berkeley, CA 94704-3298
Phone
(765) 413-1900
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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 34008095A IN Primary

Addresses

Primary practice location

2375 Shattuck Ave
Berkeley, CA 94704-3298

Mailing address

815 Regal Rd
Berkeley, CA 94708-1307
Phone (765) 413-1900

Other practice location 1

2827 Concord Blvd
Concord, CA 94519-2608
Phone (925) 685-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 3, 2025 through Feb 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34008095AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Step Forward Past Accepting new patients

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1235634288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 REGAL RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081307",
            "telephone_number": "765-413-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043298",
            "telephone_number": "765-413-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Concord Blvd",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945192608",
            "country_code": "US",
            "telephone_number": "925-685-9670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABB",
        "first_name": "ALEXA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008095A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.