Individual provider Active NPI

Jonathan R Botson, MSW

  • Social Worker
  • San Rafael, CA
National Provider Identifier
1508041633
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3270 Kerner Blvd
Suite B
San Rafael, CA 94901-4840
Phone
(415) 473-4128
Fax
(415) 473-4114
NPI assigned
Jan 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3270 Kerner Blvd
Suite B
San Rafael, CA 94901-4840

Mailing address

3270 Kerner Blvd.
Suite B
San Rafael, CA 94901
Phone (415) 473-4128

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

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1508041633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 KERNER BLVD.",
            "address_2": "SUITE B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-473-4128",
            "fax_number": "415-473-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 KERNER BLVD",
            "address_2": "SUITE B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-4128",
            "fax_number": "415-473-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTSON",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.