Individual provider Active NPI

Keiko Fukue, MSW, ASW

  • Clinical Social Worker
  • Ventura, CA
National Provider Identifier
1265802490
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
81071 Issued in CA
Practice address
200 Hillmont Ave
Ventura, CA 93003-1647
Phone
(805) 652-6729
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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 81071 CA Primary

Addresses

Primary practice location

200 Hillmont Ave
Ventura, CA 93003-1647

Mailing address

200 Hillmont Ave
Ventura, CA 93003-1647
Phone (805) 652-6729

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
81071CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1265802490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031647",
            "telephone_number": "805-652-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031647",
            "telephone_number": "805-652-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUE",
        "first_name": "KEIKO",
        "credential": "MSW, ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "81071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.