Active NPI
Jane Altavas Sia-Flaherty, LCSW
- Clinical Social Worker
- Berkeley, CA
National Provider Identifier
1467887083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW102483
- Practice address
- 2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151 - Phone
- (510) 764-3787
- NPI assigned
- Sep 13, 2013
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW 66918 | CA | |
| Clinical Social Worker | 1041C0700X | 1014YA0400X | CA | |
| Clinical Social Worker | 1041C0700X | 102483 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW102483 | CA | Primary |
Addresses
Primary practice location
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Mailing address
3288 Adams Ave Unit 16773
San Diego, CA 92176-7032
Phone (619) 259-0507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014YA0400X | Medicaid | CA |
Other names 1
- Jane Altavas Sia
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 |
|---|---|---|---|
| ASW 66918 | CA | MD | Mental Health Counselor |
| 1014YA0400X | CA | MD | Clinical Social Worker |
| 102483 | CA | MD | Clinical Social Worker |
| LCSW102483 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1467887083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3288 ADAMS AVE UNIT 16773",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921767032",
"telephone_number": "619-259-0507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2855 TELEGRAPH AVE STE 515",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051151",
"telephone_number": "510-764-3787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIA-FLAHERTY",
"first_name": "JANE",
"middle_name": "ALTAVAS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-13",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW 66918",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "1014YA0400X",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "102483",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW102483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1014YA0400X",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JANE",
"last_name": "SIA",
"middle_name": "ALTAVAS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.