Individual provider Active NPI

Simonetta Fosci, MSW

  • Clinical Social Worker
  • San Quentin, CA
National Provider Identifier
1487833596
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61362 Issued in CA
Practice address
1 Main St
San Quentin, CA 94964-1000
Phone
(415) 454-1460
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 61362 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1 Main St
San Quentin, CA 94964-1000

Mailing address

7450 Northrop Dr Apt 88
Riverside, CA 92508-5005
Phone (951) 776-9443

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

LicenseStateTypeSpecialty
61362CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters CurrentSince Sep 4, 2022 Accepting new patients

Locations

1 Main St
San Quentin, CA 94964
Phone (415) 721-3590

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1487833596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 NORTHROP DR APT 88",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925085005",
            "telephone_number": "951-776-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "SAN QUENTIN",
            "state": "CA",
            "postal_code": "949641000",
            "telephone_number": "415-454-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSCI",
        "first_name": "SIMONETTA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "61362",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Quentin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.