Individual provider Active NPI

Abby Mitchell Ouji, LCSW

  • Clinical Social Worker
  • San Pablo, CA
National Provider Identifier
1447509187
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
85167 Issued in CA
Practice address
2023 Vale Rd
San Pablo, CA 94806-3834
Phone
(510) 215-9092
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 85167 CA Primary

Addresses

Primary practice location

2023 Vale Rd
San Pablo, CA 94806-3834

Mailing address

2023 Vale Rd
San Pablo, CA 94806-3834
Phone (510) 215-9092

Other identifiers 2

IdentifierTypeStateIssuer
1447509187MedicaidCA
1447509187MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220426003043 NJ Practitioner - Clinical Social Worker 8527455351 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85167CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Medical Center, Inc. CurrentSince May 18, 2022 Accepting new patients
Central Jersey Medical Center, Inc CurrentSince May 18, 2022 Accepting new patients

Locations

80 Johnson Ave
Newark, NJ 07108
Phone (973) 623-8592

275 Hobart St
Perth Amboy, NJ 08861
Phone (732) 376-6635

Interoperability endpoints

  • Direct secure messaging: abby.ouji.1@16647.direct.athenahealth.com

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": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1447509187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 VALE RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063834",
            "telephone_number": "510-215-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 VALE RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063834",
            "telephone_number": "510-215-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUJI",
        "first_name": "ABBY",
        "middle_name": "MITCHELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "85167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447509187",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447509187",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.