Individual provider Active NPI

Turnip Alana Mystery Van Dyke

  • Clinical Social Worker
  • San Leandro, CA
National Provider Identifier
1396690608
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW136906 Issued in CA
Practice address
400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone
(510) 924-0548
NPI assigned
Mar 2, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 ASW136906 CA Primary

Addresses

Primary practice location

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962

Mailing address

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone (510) 924-0548

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

LicenseStateTypeSpecialty
ASW136906CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1396690608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-924-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-924-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "TURNIP",
        "middle_name": "ALANA MYSTERY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW136906",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 13, 2026; 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.