Individual provider Active NPI

Kevin Givan

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1306256722
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW 35325 Issued in CA
Practice address
1317 Fruitdale Ave
San Jose, CA 95126-4083
Phone
(310) 782-4565
NPI assigned
May 7, 2014
Last updated
May 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 35325 CA Primary

Addresses

Primary practice location

1317 Fruitdale Ave
San Jose, CA 95126-4083

Mailing address

PO Box 730276
San Jose, CA 95173-0276
Phone (408) 971-9822

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

LicenseStateTypeSpecialty
ASW 35325CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1306256722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730276",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951730276",
            "telephone_number": "408-971-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 FRUITDALE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951264083",
            "telephone_number": "310-782-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVAN",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 35325",
            "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 May 7, 2014; 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.