Active NPI
Maureen Costello Orphanos, LCSW
- Clinical Social Worker
- Fremont, CA
National Provider Identifier
1437287646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS18754
- Practice address
- 39155 Liberty St Ste G710
Fremont, CA 94538-1525 - Phone
- (510) 795-2434
- Fax
- (510) 793-3972
- NPI assigned
- Mar 1, 2007
- 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 | LCS18754 | CA | Primary |
Addresses
Primary practice location
39155 Liberty St Ste G710
Fremont, CA 94538-1525
Mailing address
39155 Liberty St Ste G710
Fremont, CA 94538-1525
Phone (510) 795-2434
Other practice location 1
7200 Bancroft Ave
Suite 125A
Oakland, CA 94605-2403
Phone (510) 777-3851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS18754 | Other | CA | SOCIAL WORK LISCENSE |
Other names 1
- Maureen Costello
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS18754 | CA | MD | Clinical Social Worker |
| 18754 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1437287646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39155 LIBERTY ST STE G710",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381525",
"telephone_number": "510-795-2434",
"fax_number": "510-793-3972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39155 LIBERTY ST STE G710",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381525",
"telephone_number": "510-795-2434",
"fax_number": "510-793-3972"
}
],
"practiceLocations": [
{
"address_1": "7200 Bancroft Ave",
"address_2": "Suite 125A",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946052403",
"country_code": "US",
"telephone_number": "510-777-3851",
"fax_number": "510-777-3806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORPHANOS",
"first_name": "MAUREEN",
"middle_name": "COSTELLO",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS18754",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK LISCENSE",
"identifier": "LCS18754",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAUREEN",
"last_name": "COSTELLO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.