Active NPI
Maritsa Garcia Rendon
- Social Worker
- Gilroy, CA
National Provider Identifier
1497338479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW113094
- Practice address
- 290 Ioof Ave
Gilroy, CA 95020-5204 - Phone
- (408) 846-2100
- Fax
- (408) 842-8815
- NPI assigned
- Apr 28, 2021
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CA | ||
| Mental Health Counselor | 101YM0800X | 113094 | CA | |
| Clinical Social Worker | 1041C0700X | 113094 | CA | |
| Counselor | 101Y00000X | 113094 | CA | |
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Social Worker | 104100000X | ASW113094 | CA | Primary |
Addresses
Primary practice location
290 Ioof Ave
Gilroy, CA 95020-5204
Mailing address
290 Ioof Ave
Gilroy, CA 95020-5204
Phone (408) 846-2100
Other practice location 1
777 N 1st St Ste 44
San Jose, CA 95112-6337
Phone (408) 240-0070
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 |
|---|---|---|---|
| ASW113094 | CA | MD | Social Worker |
| 113094 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1497338479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 IOOF AVE",
"city": "GILROY",
"state": "CA",
"postal_code": "950205204",
"telephone_number": "408-846-2100",
"fax_number": "408-842-9915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 IOOF AVE",
"city": "GILROY",
"state": "CA",
"postal_code": "950205204",
"telephone_number": "408-846-2100",
"fax_number": "408-842-8815"
}
],
"practiceLocations": [
{
"address_1": "777 N 1st St Ste 44",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951126337",
"country_code": "US",
"telephone_number": "408-240-0070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARCIA RENDON",
"first_name": "MARITSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-28",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "113094",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "113094",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "113094",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW113094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilroy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.