Active NPI
Lindsey Derutte
- Social Worker
- Sebastopol, CA
National Provider Identifier
1336902741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW126016
- Practice address
- 438 Eddie LN
Sebastopol, CA 95472-3425 - Phone
- (707) 823-8722
- NPI assigned
- Jan 31, 2024
- Last updated
- Oct 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW126016 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
438 Eddie LN
Sebastopol, CA 95472-3425
Mailing address
438 Eddie LN
Sebastopol, CA 95472-3425
Phone (707) 849-1524
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 |
|---|---|---|---|
| ASW126016 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1336902741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 EDDIE LN",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723425",
"telephone_number": "707-849-1524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 EDDIE LN",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723425",
"telephone_number": "707-823-8722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUTTE",
"first_name": "LINDSEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-31",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW126016",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.