Individual provider Active NPI

Brandy Aiesha Walker, LCSW, LMSW

  • Clinical Social Worker
  • Berkeley, CA
National Provider Identifier
1417629965
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109682 Issued in CA
Practice address
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Phone
(510) 478-4029
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 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 CSW007874 GA
Clinical Social Worker 1041C0700X 109682 CA Primary

Addresses

Primary practice location

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151

Mailing address

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Phone (510) 478-4029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220204000446 GA Practitioner - Clinical Social Worker 1951794429 Reassigns benefits to 1 organization
I20260306000502 CA Practitioner - Clinical Social Worker 1951794429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2393 Townsgate Rd
Suite 104
Westlake Village, CA 91361-2509

PO Box
Suite 761
Fairburn, GA 30213-0761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109682CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Heritage Medical Group Inc CurrentSince Jan 20, 2026 Accepting new patients
Total Life Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

110 Front St
Ste 300
Jupiter, FL 33477
Phone (205) 246-5690

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1417629965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "510-478-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "510-478-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRANDY",
        "middle_name": "AIESHA",
        "credential": "LCSW, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007874",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.