Nicole Sudduth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26232 Issued in CA

Practice address

2071 Antioch CT
Suite 201a
Oakland, CA 94611-2955

Phone

(510) 457-1346

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The West Oakland Health Council

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
  • NPI 1043331630
  NPD
• The West Oakland Health Council

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1285754234
  NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1427269380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 ANTIOCH CT",
            "address_2": "SUITE 201A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946112955",
            "telephone_number": "510-457-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 ANTIOCH CT",
            "address_2": "SUITE 201A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946112955",
            "telephone_number": "510-457-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Subacute Treatment for Adolescent Rehabilitation Services, Inc.
• Subacute Treatment for Adolescent Rehabilitation Services, Inc.
• Aishwarya Raji Subramanian
• Sonia Subudhi, MD
• Arlene R Suda, PT
• Christopher Michael Sue, M.D.
• Phoebe Suehiro
• Halton Suen, DDS
• Asuka Sugano
• Tessa Sugarbaker, M.D.

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.