Individual provider Active NPI

William Smith

  • Clinical Social Worker
  • Marina, CA
National Provider Identifier
1568988681
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
617 Bayonet Cir
Marina, CA 93933
Phone
(831) 384-7251
NPI assigned
Aug 21, 2017
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

617 Bayonet Cir
Marina, CA 93933

Mailing address

617 Bayonet Cir
Marina, CA 93933-4600
Phone (831) 384-7251

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220620000634 CA Practitioner - Clinical Social Worker 8325427578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107975CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Interim, Inc. Current Accepting new patients
Interim, Inc. CurrentSince Feb 28, 2025 Accepting new patients

Locations

339 Pajaro St
Salinas, CA 93901
Phone (831) 800-7530

339 Pajaro St
Ste C
Salinas, CA 93901

41 E San Luis St
Salinas, CA 93901
Phone (831) 676-3715

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1568988681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 BAYONET CIR",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939334600",
            "telephone_number": "831-384-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BAYONET CIR",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "93933",
            "telephone_number": "831-384-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.