Active NPI
Jennifer Dawn Pearce Azam, LCSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1528658606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW96532
- Practice address
- 6742 Pinehaven Rd
Oakland, CA 94611-1014 - Phone
- (978) 857-5104
- NPI assigned
- Jan 22, 2021
- 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 | LCSW96532 | CA | Primary |
Addresses
Primary practice location
6742 Pinehaven Rd
Oakland, CA 94611-1014
Mailing address
6742 Pinehaven Rd
Oakland, CA 94611-1014
Phone (978) 857-5104
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 |
|---|---|---|---|
| LCSW96532 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1528658606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6742 PINEHAVEN RD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111014",
"telephone_number": "978-857-5104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6742 PINEHAVEN RD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111014",
"telephone_number": "978-857-5104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAM",
"first_name": "JENNIFER",
"middle_name": "DAWN PEARCE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-22",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW96532",
"primary": true
}
],
"identifiers": [],
"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 Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.