Individual provider Active NPI

Taimur Khan, LCSW

  • Clinical Social Worker
  • Fremont, CA
National Provider Identifier
1376977108
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
91957 Issued in CA
Practice address
39199 Liberty St
Fremont, CA 94538-1501
Phone
(510) 791-4000
NPI assigned
Aug 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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 91957 CA Primary

Addresses

Primary practice location

39199 Liberty St
Fremont, CA 94538-1501

Mailing address

39199 Liberty St
Fremont, CA 94538-1501
Phone (510) 791-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A Other

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
91957CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1376977108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39199 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381501",
            "telephone_number": "510-791-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39199 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381501",
            "telephone_number": "510-791-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TAIMUR",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "975 Kirman Ave",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895020997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.