Albert R Mezistrano, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61339056 Issued in WA

Practice address

74 Barnes CT
Apt 316
Stanford, CA 94305

Phone

(206) 651-4069

NPI assigned

Feb 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1295235406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 EL CAMINO REAL STE 120",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254884",
            "telephone_number": "206-651-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BARNES CT",
            "address_2": "APT 316",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "206-651-4069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4803B S Mayflower St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981182351",
            "country_code": "US",
            "telephone_number": "206-351-9985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZISTRANO",
        "first_name": "ALBERT",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61339056",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW118091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Meuter, PA
• Courtney Morgan Meyer, MS, ATC
• Everett Hurteau Meyer, MD PHD
• Justin Gabriel Meyerowitz, MD
• Samuel Jess Meza, MD
• Susanna Yanqing Miao, MD
• Aaron Micflikier
• Kristina Michelle Michaudet, MD
• Sara Michie, MD
• Carolyn Miclean

• Clinical Social Worker in Stanford, CA
• Providers in Stanford, 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 Feb 16, 2024; 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.