NPIMap

Individual provider Active NPI

Talia Davidow

  • Social Worker
  • Berkeley, CA
National Provider Identifier
1386003994
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
63350 Issued in CA
Practice address
3214 California St Uppr
Berkeley, CA 94703-2614
Phone
(650) 269-2285
NPI assigned
Feb 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 63350 CA
Social Worker 104100000X 63350 CA Primary

Addresses

Primary practice location

3214 California St Uppr
Berkeley, CA 94703-2614

Mailing address

2344 6TH St
Berkeley, CA 94710-2412
Phone (510) 981-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517003134 CA Practitioner - Clinical Social Worker 2961889795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelong Medical CareGroup PAC ID 2062304538, 75 clinicians

Practice addresses (Care Compare)

3260 Sacramento St
Berkeley, CA 94702-2739
Phone (510) 428-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63350CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince May 5, 2022 Accepting new patients
Lifelong Medical Care CurrentSince May 5, 2022 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1386003994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102412",
            "telephone_number": "510-981-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 CALIFORNIA ST UPPR",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032614",
            "telephone_number": "650-269-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOW",
        "first_name": "TALIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "63350",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "63350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.