Active NPI
Jennifer Spevak
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1285012617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 71542
- Practice address
- 2116 Broadway
Oakland, CA 94612-2310 - Phone
- (510) 899-4110
- NPI assigned
- May 18, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 71542 | CA | Primary |
Addresses
Primary practice location
2116 Broadway
Oakland, CA 94612-2310
Mailing address
2116 Broadway
Oakland, CA 94612-2310
Phone (510) 899-4110
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814004135 | CA | Order and Referring Only - Clinical Social Worker | 3476091927 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71542 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1285012617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2116 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946122310",
"telephone_number": "510-899-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2116 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946122310",
"telephone_number": "510-899-4110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEVAK",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-18",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "71542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.