Individual provider Active NPI

Michelle Nelly Renteria

  • Social Worker
  • Gilroy, CA
National Provider Identifier
1265913487
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW104394 Issued in CA
Practice address
290 Ioof Ave
Gilroy, CA 95020-5204
Phone
(408) 846-2100
NPI assigned
Aug 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW104394 CA Primary
Clinical Social Worker 1041C0700X LCSW135648 CA
Clinical Social Worker 1041C0700X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

290 Ioof Ave
Gilroy, CA 95020-5204

Mailing address

290 Ioof Ave
Gilroy, CA 95020-5204

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
ASW104394CAMDSocial Worker
LCSW135648CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1535155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1265913487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 IOOF AVE",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 IOOF AVE",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950205204",
            "telephone_number": "408-846-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTERIA",
        "first_name": "MICHELLE",
        "middle_name": "NELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-25",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW104394",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW135648",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.