Kevin Todd Sacks

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

83694 Issued in CA

Practice address

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Phone

(831) 454-2080

NPI assigned

Jun 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1275739088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE.",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS",
        "first_name": "KEVIN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MENTAL HEALTH MEDICARE GROUP PTAN#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MENTAL HEALTH MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tami Ryder, LPT
• Zoe Rygg
• Alania Sabankaya, MS
• Michelle Marie Sablan, M.D.
• Alicia Faith Sackett
• Safeway Inc
• Safeway Inc
• Taji Saffarian
• Ronald James Sager, M.D.
• Nupur Sahai, PH. D.

• Clinical Social Worker in Santa Cruz, CA
• Providers in Santa Cruz, 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 Jun 15, 2023; 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.