Active NPI
Regina Eliza Camacho, LCSW
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1366691362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW68521
- Practice address
- 1555 Parkmoor Ave
San Jose, CA 95128-2407 - Phone
- (408) 282-0402
- Fax
- (408) 282-0400
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | LCSW68521 | CA | Primary |
Addresses
Primary practice location
1555 Parkmoor Ave
San Jose, CA 95128-2407
Mailing address
80 Great Oaks Blvd
B-502
San Jose, CA 95119
Phone (408) 363-3000
Other names 1
- Regina Eliza Acosta
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 |
|---|---|---|---|
| LCSW68521 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Services | Past | Accepting new patients | |
| Hope Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Mountain View, CA
- NPI 1043571730
-
- Community/Behavioral Health Agency
- San Jose, CA
- NPI 1861445306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1366691362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 GREAT OAKS BLVD",
"address_2": "B-502",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95119",
"telephone_number": "408-363-3000",
"fax_number": "408-363-3046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 PARKMOOR AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282407",
"telephone_number": "408-282-0402",
"fax_number": "408-282-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "REGINA",
"middle_name": "ELIZA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW68521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REGINA",
"last_name": "ACOSTA",
"middle_name": "ELIZA",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.