Individual provider Active NPI

John Richard Dovales Flores, ACSW

  • Social Worker
  • Oakland, CA
National Provider Identifier
1316426935
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
111143 Issued in CA
Practice address
3800 Coolidge Ave
Oakland, CA 94602-3399
Phone
(209) 355-8896
NPI assigned
Aug 14, 2018
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111143 CA Primary

Addresses

Primary practice location

3800 Coolidge Ave
Oakland, CA 94602-3399

Mailing address

456 Wayne Ave
Oakland, CA 94606-1166
Phone (209) 355-8896

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
111143CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1316426935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946061166",
            "telephone_number": "209-355-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 COOLIDGE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946023399",
            "telephone_number": "209-355-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVALES FLORES",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "111143",
            "primary": true
        }
    ],
    "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 Dec 22, 2023; 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.