Paul Mark Gibson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS11218 Issued in CA

Practice address

545 Estudillo Ave
San Leandro, CA 94577-4611

Phone

(510) 352-9200

Fax

(510) 352-3120

NPI assigned

Mar 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1548394133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 EUREKA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142715",
            "telephone_number": "415-282-9100",
            "fax_number": "415-282-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 ESTUDILLO AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774611",
            "telephone_number": "510-352-9200",
            "fax_number": "510-352-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PAUL",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS11218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Giang
• Paul Son Giang, PHARMD
• Erica Lindsay Gibbert
• Andreia Gwenette Gibbs
• Lisa Dawn Gibbs, RN
• Robin Gibson
• Bridgette Heidi Gifford
• Andrea Gil
• Jesenia Janeth Gil, LCSW
• Brian Gilbane, LCSW

• Clinical Social Worker in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.