NPIMap

Individual provider Active NPI

Shira Jordan, LCSW 29372

  • Clinical Social Worker
  • San Leandro, CA
National Provider Identifier
1568799286
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29372 Issued in CA
Practice address
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone
(510) 317-1444
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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 27094 CA
Clinical Social Worker 1041C0700X 29372 CA Primary

Addresses

Primary practice location

2275 Arlington Dr
San Leandro, CA 94578-1132

Mailing address

2275 Arlington Dr
San Leandro, CA 94578-1132

Other names 1

  • Shira Jindal Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
29372CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Center Past Accepting new patients
Rocketship Education Wisconsin Inc. Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1568799286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 ARLINGTON DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 ARLINGTON DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781132",
            "telephone_number": "510-317-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SHIRA",
        "credential": "LCSW 29372",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27094",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRA",
            "last_name": "JINDAL",
            "credential": "LCSW 29372",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.