Individual provider Active NPI

Adriana Yepez

  • Clinical Social Worker
  • San Mateo, CA
National Provider Identifier
1306496351
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
96593 Issued in CA
Practice address
2000 Alameda de Las Pulgas
San Mateo, CA 94403-1269
Phone
(650) 573-2630
NPI assigned
Sep 11, 2019
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 96593 CA Primary

Addresses

Primary practice location

2000 Alameda de Las Pulgas
San Mateo, CA 94403-1269

Mailing address

5109 Bogart Dr
Ceres, CA 95307-9767

Other practice location 1

420 E Canal Dr
Turlock, CA 95380-3936
Phone (209) 669-2583

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
96593CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1306496351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 BOGART DR",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953079767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031269",
            "telephone_number": "650-573-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E Canal Dr",
            "address_purpose": "LOCATION",
            "city": "Turlock",
            "state": "CA",
            "postal_code": "953803936",
            "country_code": "US",
            "telephone_number": "209-669-2583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEPEZ",
        "first_name": "ADRIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.