Individual provider Active NPI

Peggy Ann Alfred, LCSW

  • Specialist
  • Campbell, CA
National Provider Identifier
1437482726
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LCS 17019 Issued in CA
Practice address
3425 S Bascom Ave Ste F
Campbell, CA 95008-7300
Phone
(408) 559-6974
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LCS 17019 CA Primary

Addresses

Primary practice location

3425 S Bascom Ave Ste F
Campbell, CA 95008-7300

Mailing address

3425 S Bascom Ave Ste F
Campbell, CA 95008-7300
Phone (408) 559-6974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 30, 2024 through Jan 30, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCS 17019CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1437482726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE STE F",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-559-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE STE F",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-559-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFRED",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "LCS 17019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.