Kari Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 22142 Issued in CA

Practice address

1240 Powell St
Ste 2-D
Emeryville, CA 94608-2600

Phone

(510) 393-0171

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifelong Medical Care

  • Geriatric Medicine (Family Medicine) Physician
  • Berkeley, CA
  • NPI 1689670002
  Medicare reassignment

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1356478978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 POWELL ST",
            "address_2": "STE 2-D",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082600",
            "telephone_number": "510-393-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 POWELL ST",
            "address_2": "STE 2-D",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082600",
            "telephone_number": "510-393-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KARI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawara K Payne
• Alondra Perea
• Arely Perez Sanchez
• Daniel R Perlov, M.D.
• Janai Christine Perry
• Betty Ellen Peterson, M.ED.
• Lori Michelle Petroff, PA-C
• Parissa Peymani, D.C.
• Marydang Phanixay
• Cheavlay Phat

• Clinical Social Worker in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.