Individual provider Active NPI

Judith M Quittman, LCSW

  • Clinical Social Worker
  • San Pablo, CA
National Provider Identifier
1386771533
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 22494 Issued in CA
Practice address
13585 San Pablo Ave
San Pablo, CA 94806
Phone
(510) 942-4700
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCS 22494 CA
Clinical Social Worker 1041C0700X LCS 22494 CA Primary

Addresses

Primary practice location

13585 San Pablo Ave
San Pablo, CA 94806

Mailing address

13585 San Pablo Ave
San Pablo, CA 94806
Phone (510) 942-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110222000931 CA Practitioner - Clinical Social Worker 5698956753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians

Practice addresses (Care Compare)

2523 El Portal Dr
San Pablo, CA 94806-3305
Phone (510) 215-3730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 22494CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Nov 27, 2010 Accepting new patients
Contra Costa County CurrentSince Nov 27, 2010 Accepting new patients
Contra Costa County Past Accepting new patients

Locations

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

2523 El Portal Dr
Ste 103
San Pablo, CA 94806
Phone (510) 215-3730

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1386771533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806",
            "telephone_number": "510-942-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13585 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "94806",
            "telephone_number": "510-942-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUITTMAN",
        "first_name": "JUDITH",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-06-03",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS 22494",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.