Individual provider Active NPI

Patricia-Ann Bossert, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1497810154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 17091 Issued in CA
Practice address
3190 S Bascom Ave
Ste. 180
San Jose, CA 95124-2569
Phone
(408) 380-1215
Fax
(408) 441-0924
NPI assigned
Dec 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 17091 CA Primary

Addresses

Primary practice location

3190 S Bascom Ave
Ste. 180
San Jose, CA 95124-2569

Mailing address

1274 San Juan Ave
San Jose, CA 95110-1469
Phone (408) 380-1215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122002505 CA Practitioner - Clinical Social Worker 6709275233 Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3190 S Bascom Ave
Suite 180
San Jose, CA 95124-2568
Phone (408) 380-1215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 17091CAMDClinical Social Worker
17091CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497810154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1274 SAN JUAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101469",
            "telephone_number": "408-380-1215",
            "fax_number": "408-441-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 S BASCOM AVE",
            "address_2": "STE. 180",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242569",
            "telephone_number": "408-380-1215",
            "fax_number": "408-441-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERT",
        "first_name": "PATRICIA-ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 17091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.