Active NPI
Stephanie Banuelos
- Social Worker
- Oakland, CA
National Provider Identifier
1285462754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 139039
- Practice address
- 390 40TH St
Oakland, CA 94609-2633 - Phone
- (510) 867-1395
- NPI assigned
- Jul 25, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Health Educator | 174H00000X | CA | ||
| Social Worker | 104100000X | 139039 | CA | Primary |
| Rehabilitation Practitioner | 225400000X | CA |
Addresses
Primary practice location
390 40TH St
Oakland, CA 94609-2633
Mailing address
390 40TH St
Oakland, CA 94609-2633
Phone (510) 867-1395
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1285462754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 40TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946092633",
"telephone_number": "510-867-1395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 40TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946092633",
"telephone_number": "510-867-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANUELOS",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-25",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "139039",
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": false
}
],
"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 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.