Active NPI
Mariko Tanaka
- Social Worker
- San Mateo, CA
National Provider Identifier
1407627235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCSW7072
- Practice address
- 1586 Parrott Dr
San Mateo, CA 94402-3605 - Phone
- (650) 345-5258
- NPI assigned
- Jan 10, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCSW7072 | CA | Primary |
Addresses
Primary practice location
1586 Parrott Dr
San Mateo, CA 94402-3605
Mailing address
1586 Parrott Dr
San Mateo, CA 94402-3605
Phone (650) 888-7422
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW7072 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1407627235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1586 PARROTT DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023605",
"telephone_number": "650-888-7422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1586 PARROTT DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023605",
"telephone_number": "650-345-5258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAKA",
"first_name": "MARIKO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-10",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW7072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.