John Roy Bisenius, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20703 Issued in CA

Practice address

200 Channing Ave
Palo Alto, CA 94301-2720

Phone

(650) 688-3097

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jewish Family and Childrens Services

  • Mental Health Counselor
  • San Rafael, CA
  • NPI 1780791020
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1275547481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHANNING AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012720",
            "telephone_number": "650-388-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CHANNING AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012720",
            "telephone_number": "650-688-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISENIUS",
        "first_name": "JOHN",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "EP596Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalia Eugenia Birgisson, MD
• Andrew Charles Birkeland, M.D.
• Justin Ayala Birnbaum, M.D.
• Krista Lauren Birnie, MD
• Mardella Regala Birondo
• Arvind Kumar Bishnoi, MD
• Nancy Bishop-Abney, RN
• Allyn Bishop, DPM
• Somer L Bishop, PH.D.
• Elaine Bisona

• Clinical Social Worker in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.