Active NPI
Martha Bader, LCSW
- Clinical Social Worker
- San Leandro, CA
National Provider Identifier
1366937476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 94856
- Practice address
- 15400 Foothill Blvd BLDG C2F
San Leandro, CA 94578-1009 - Phone
- (510) 895-4370
- Fax
- (510) 895-4583
- NPI assigned
- Jun 30, 2018
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 74278 | CA | |
| Clinical Social Worker | 1041C0700X | 94856 | CA | Primary |
Addresses
Primary practice location
15400 Foothill Blvd BLDG C2F
San Leandro, CA 94578-1009
Mailing address
484 Lake Park Ave # 541
Oakland, CA 94610-2730
Phone (510) 387-9487
Other practice location 1
188 S Grove St
Asheville, NC 28801-3938
Phone (510) 473-7397
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94856 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
| C013153 | Other | NC | NC SOCIAL WORK AND CERTIFICATION BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74278 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1366937476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 LAKE PARK AVE # 541",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946102730",
"telephone_number": "510-387-9487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15400 FOOTHILL BLVD BLDG C2F",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781009",
"telephone_number": "510-895-4370",
"fax_number": "510-895-4583"
}
],
"practiceLocations": [
{
"address_1": "188 S Grove St",
"address_purpose": "LOCATION",
"city": "Asheville",
"state": "NC",
"postal_code": "288013938",
"country_code": "US",
"telephone_number": "510-473-7397",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BADER",
"first_name": "MARTHA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-30",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "74278",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "94856",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "94856",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC SOCIAL WORK AND CERTIFICATION BOARD",
"identifier": "C013153",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.