Individual provider Active NPI

Jose Guadaupe Hurtado, LCSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1528240868
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW76919 Issued in CA
Practice address
10901 Macarthur Blvd Ste 201
Oakland, CA 94605
Phone
(510) 502-3280
Fax
(510) 868-1940
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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 LCSW76919 CA Primary

Addresses

Primary practice location

10901 Macarthur Blvd Ste 201
Oakland, CA 94605

Mailing address

2600 San Leandro Blvd Apt 1319
San Leandro, CA 94578-5048
Phone (831) 600-5175

Other practice location 1

303 W Joaquin Ave Ste 110
San Leandro, CA 94577-3667
Phone (510) 878-8709

Other practice location 2

20835 Chester St Ste A
Castro Valley, CA 94546-5515
Phone (510) 502-3280

Other identifiers 2

IdentifierTypeStateIssuer
LCSW76919OtherCABOARD OF BEHAVIO
LCSW76919OtherCABOARD OF BEHAVIORAL SCIENCES CALIFORNIA

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

LicenseStateTypeSpecialty
LCSW76919CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1528240868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SAN LEANDRO BLVD APT 1319",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945785048",
            "telephone_number": "831-600-5175",
            "fax_number": "510-868-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 MACARTHUR BLVD STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94605",
            "telephone_number": "510-502-3280",
            "fax_number": "510-868-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W Joaquin Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945773667",
            "country_code": "US",
            "telephone_number": "510-878-8709",
            "fax_number": "510-686-8832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20835 Chester St Ste A",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465515",
            "country_code": "US",
            "telephone_number": "510-502-3280",
            "fax_number": "510-868-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "JOSE",
        "middle_name": "GUADAUPE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW76919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIO",
            "identifier": "LCSW76919",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES CALIFORNIA",
            "identifier": "LCSW76919",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.