Individual provider Active NPI

Kay I. Bunnell Coddington, L.C.S.W., A.C.S.W.

  • Clinical Social Worker
  • San Mateo, CA
National Provider Identifier
1366572273
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7369 Issued in CA
Practice address
520 S El Camino Real
Ste. 204
San Mateo, CA 94402-1726
Phone
(650) 872-0603
Fax
(650) 343-8244
NPI assigned
Mar 7, 2007
Last updated
Jul 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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 7369 CA Primary

Addresses

Primary practice location

520 S El Camino Real
Ste. 204
San Mateo, CA 94402-1726

Mailing address

520 S El Camino Real
Ste. 204
San Mateo, CA 94402-1726
Phone (650) 872-0603

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
7369CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1366572273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S EL CAMINO REAL",
            "address_2": "STE. 204",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021726",
            "telephone_number": "650-872-0603",
            "fax_number": "650-343-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EL CAMINO REAL",
            "address_2": "STE. 204",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021726",
            "telephone_number": "650-872-0603",
            "fax_number": "650-343-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL CODDINGTON",
        "first_name": "KAY",
        "middle_name": "I.",
        "credential": "L.C.S.W., A.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "7369",
            "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 Jul 25, 2012; 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.