Active NPI
Amanda M Cosio-Bognuda-Corcoran, LCSW
- Clinical Social Worker
- San Luis Obispo, CA
National Provider Identifier
1497062236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 82927
- Practice address
- 2180 Johnson Ave
San Luis Obispo, CA 93401-4513 - Phone
- (805) 781-4997
- NPI assigned
- Aug 31, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW 64535 | CA | |
| Clinical Social Worker | 1041C0700X | 82927 | CA | Primary |
Addresses
Primary practice location
2180 Johnson Ave
San Luis Obispo, CA 93401-4513
Mailing address
2180 Johnson Ave
San Luis Obispo, CA 93401-4513
Phone (805) 781-4997
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 64535 | CA | MD | Clinical Social Worker |
| 82927 | CA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1497062236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014513",
"telephone_number": "805-781-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014513",
"telephone_number": "805-781-4997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSIO-BOGNUDA-CORCORAN",
"first_name": "AMANDA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-31",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW 64535",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "82927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.