Individual provider Active NPI

Diana Christine Wilson, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1457697963
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS28156 Issued in CA
Practice address
950 W Julian St
San Jose, CA 95126-2719
Phone
(408) 929-3532
Fax
(408) 287-3104
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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 LCS28156 CA Primary

Addresses

Primary practice location

950 W Julian St
San Jose, CA 95126-2719

Mailing address

3759 Jenkins Ave.
San Jose, CA 95118-2719
Phone (408) 228-2333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220803003428 CA Practitioner - Clinical Social Worker 5294117420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS28156CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Caminar Current Accepting new patients
Caminar CurrentSince Apr 22, 2022 Accepting new patients

Locations

950 W Julian St
San Jose, CA 95126
Phone (408) 282-9353

2600 S El Camino Real
Ste 200
San Mateo, CA 94403
Phone (650) 372-4080

411 Borel Ave
Ste 101
San Mateo, CA 94402
Phone (650) 372-4080

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1457697963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3759 JENKINS AVE.",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951182719",
            "telephone_number": "408-228-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W JULIAN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262719",
            "telephone_number": "408-929-3532",
            "fax_number": "408-287-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANA",
        "middle_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.