Active NPI
Iman Kanj, MSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1447531207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 33665
- Practice address
- 3800 Coolidge Ave
Oakland, CA 94602-3311 - Phone
- (510) 485-5352
- NPI assigned
- Sep 7, 2011
- 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 | 33665 | CA | Primary |
Addresses
Primary practice location
3800 Coolidge Ave
Oakland, CA 94602-3311
Mailing address
3800 Coolidge Ave
Oakland, CA 94602-3311
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33665 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endurance- a Sports and Psychology Center, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Berkeley, CA
- NPI 1184041014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359504000000",
"number": "1447531207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 COOLIDGE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946023311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 COOLIDGE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946023311",
"telephone_number": "510-485-5352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANJ",
"first_name": "IMAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2013-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "33665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.