Active NPI
Chris Engelstad
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1295563666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21918
- Practice address
- 150 W Hedding St
San Jose, CA 95110-1706 - Phone
- (408) 505-9147
- NPI assigned
- Jul 25, 2024
- Sex
- Male
- 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 | 21918 | CA | Primary |
Addresses
Primary practice location
150 W Hedding St
San Jose, CA 95110-1706
Mailing address
150 W Hedding St
San Jose, CA 95110-1706
Phone (408) 505-9147
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21918 | CA | MD | Professional Counselor |
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": "1721865600000",
"number": "1295563666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 W HEDDING ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951101706",
"telephone_number": "408-505-9147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 W HEDDING ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951101706",
"telephone_number": "408-505-9147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGELSTAD",
"first_name": "CHRIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-25",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "21918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.