Active NPI
Devorah Herzog, LCSW
- Clinical Social Worker
- Woodland, CA
National Provider Identifier
1437234481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS21784
- Practice address
- 455 1St St
Woodland, CA 95695-4023 - Phone
- (530) 662-2211
- Fax
- (530) 662-4315
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS21784 | CA | Primary |
Addresses
Primary practice location
455 1St St
Woodland, CA 95695-4023
Mailing address
455 1St St
Woodland, CA 95695-4023
Phone (530) 662-2211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10201 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 1, 2024 through Nov 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21784 | CA | MD | Clinical Psychologist |
| LCS21784 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1437234481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 1ST ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956954023",
"telephone_number": "530-662-2211",
"fax_number": "530-662-4315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 1ST ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956954023",
"telephone_number": "530-662-2211",
"fax_number": "530-662-4315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZOG",
"first_name": "DEVORAH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS21784",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10201",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.