Active NPI
Chanel Sotelo, LCSW
- Clinical Social Worker
- San Carlos, CA
National Provider Identifier
1497177828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114682
- Practice address
- 940 Laurel St # a
San Carlos, CA 94070-3934 - Phone
- (650) 640-9681
- NPI assigned
- Jan 21, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 114682 | CA | Primary |
Addresses
Primary practice location
940 Laurel St # a
San Carlos, CA 94070-3934
Mailing address
155 S 300 W
Salt Lake City, UT 84101-1217
Phone (801) 467-6060
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 |
|---|---|---|---|
| 114682 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1497177828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 S 300 W",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841011217",
"telephone_number": "801-467-6060",
"fax_number": "801-486-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 LAUREL ST # A",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940703934",
"telephone_number": "650-640-9681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTELO",
"first_name": "CHANEL",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-21",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "114682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.