Active NPI
Roslyn Celeste Mincey
- Clinical Social Worker
- Palo Alto, CA
National Provider Identifier
1528455870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW63743
- Practice address
- 3801 Miranda Ave
Palo Alto, CA 94304-1207 - Phone
- (209) 857-1895
- Fax
- (209) 557-6235
- NPI assigned
- Apr 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW63743 | CA | Primary |
Addresses
Primary practice location
3801 Miranda Ave
Palo Alto, CA 94304-1207
Mailing address
3801 Miranda Ave
Palo Alto, CA 94304-1207
Phone (209) 857-1895
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASW63743 | Other | CA | ASSOCIATE CLINICAL SOCIAL WORKER |
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 |
|---|---|---|---|
| ASW63743 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429747200000",
"number": "1528455870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "209-857-1895",
"fax_number": "209-557-6235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "209-857-1895",
"fax_number": "209-557-6235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINCEY",
"first_name": "ROSLYN",
"middle_name": "CELESTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-23",
"last_updated": "2015-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW63743",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOCIATE CLINICAL SOCIAL WORKER",
"identifier": "ASW63743",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.