Individual provider Active NPI

Kimberly Anne Pratt, MSW, LICSW, LCSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1528279759
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27356 Issued in CA
Practice address
55 New Montgomery St
Suite 507
San Francisco, CA 94105-3412
Phone
(415) 595-0771
NPI assigned
May 28, 2007
Last updated
May 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114040 MA
Clinical Social Worker 1041C0700X 27356 CA Primary

Addresses

Primary practice location

55 New Montgomery St
Suite 507
San Francisco, CA 94105-3412

Mailing address

PO Box 3465
Oakland, CA 94609-0465
Phone (415) 595-0771

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
I20110610000099 CA Practitioner - Clinical Social Worker 7416042254 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Bush St
Suite 918
San Francisco, CA 94104-3950
Phone (510) 428-1315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114040MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1528279759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3465",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946090465",
            "telephone_number": "415-595-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NEW MONTGOMERY ST",
            "address_2": "SUITE 507",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053412",
            "telephone_number": "415-595-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114040",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.