Brynn Michelle Vawter, LCSW 119189

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

119189 Issued in CA

Practice address

4785 N 1St St
Fresno, CA 93726-0513

Phone

(559) 448-4883

NPI assigned

Jan 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Brynn Oliver Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1568053809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260513",
            "telephone_number": "559-448-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260513",
            "telephone_number": "559-448-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAWTER",
        "first_name": "BRYNN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW 119189",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "104184",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "119189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYNN",
            "last_name": "OLIVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Priya Meena Vasudeva, DO
• Vannarin Vath
• Anne Marie Vaughan, RD
• Mary Vaughan, CADC I
• Taylor Vaughn, PT, DPT
• Magdalen Marie Vawter
• Sayra Marlen Vazquez Pacheco
• Jaira Yazmin Vazquez-Cruz
• Flavia Esmeralda Vazquez-Garcia, NP
• Vianey Vazquez-Guerrero, AMFT #127610

• Clinical Social Worker in Fresno, CA
• Providers in Fresno, 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 Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.