Individual provider Active NPI

Paul Julio Calloway

  • Social Worker
  • Oakland, CA
National Provider Identifier
1457764086
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
559 16TH St
Oakland, CA 94612-1515
Phone
(510) 613-0330
NPI assigned
Jun 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CA Primary

Addresses

Primary practice location

559 16TH St
Oakland, CA 94612-1515

Mailing address

559 16TH St
Oakland, CA 94612-1515

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
I20200127000894 CA Practitioner - Clinical Social Worker 7012342736 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86814CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Services, Inc. Current Accepting new patients
Bay Area Community Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients
Bay Area Community Services, Inc. CurrentSince Nov 4, 2019 Accepting new patients

Locations

390 40th St
Oakland, CA 94609
Phone (510) 247-8235

559 16th St
Oakland, CA 94612
Phone (510) 318-6112

Organizations & group practices 3

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": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1457764086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121515",
            "telephone_number": "510-613-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "PAUL",
        "middle_name": "JULIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.