Active NPI
Caroline Cangelosi, LCSW
- Clinical Social Worker
- Berkeley, CA
National Provider Identifier
1275659161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26700
- Practice address
- 837 Addison St
Berkeley, CA 94712 - Phone
- (510) 981-4100
- Fax
- (510) 981-4294
- NPI assigned
- Mar 22, 2007
- Last updated
- Feb 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW 21976 | CA | |
| Clinical Social Worker | 1041C0700X | 26700 | CA | Primary |
Addresses
Primary practice location
837 Addison St
Berkeley, CA 94712
Mailing address
2344 6TH St
Berkeley, CA 94710-2412
Phone (510) 981-4100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11260 | Other | SFGH INTERNAL USE ONLY | |
| 11260 | Other | CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER | |
| 132084 | Other | CA | CHN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW 21976 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelong Medical Care | Current | Accepting new patients | |
| Lifelong Medical Care | Current | Accepting new patients | |
| Lifelong Medical Care | Past | Accepting new patients |
Locations
2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203
10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300
Organizations & group practices 3
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.
-
dba Over Sixty Health Center
- Geriatric Medicine (Family Medicine) Physician
- Berkeley, CA
- NPI 1689670002
-
- Family Medicine Physician
- Rodeo, CA
- NPI 1003289463
-
dba West Berkeley Family Practice
- Adolescent Medicine (Family Medicine) Physician
- Berkeley, CA
- NPI 1720084163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1275659161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2344 6TH ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947102412",
"telephone_number": "510-981-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "837 ADDISON ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94712",
"telephone_number": "510-981-4100",
"fax_number": "510-981-4294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANGELOSI",
"first_name": "CAROLINE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2021-02-17",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW 21976",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "26700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SFGH INTERNAL USE ONLY",
"identifier": "11260",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
"identifier": "11260",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHN",
"identifier": "132084",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.