Active NPI
Elizabeth Deol, LCSW
- Social Worker
- Fairfield, CA
National Provider Identifier
1578239711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 122855
- Practice address
- 480 Chadbourne Rd
Fairfield, CA 94534-9639 - Phone
- (707) 429-4440
- NPI assigned
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 122855 | CA | Primary |
Addresses
Primary practice location
480 Chadbourne Rd
Fairfield, CA 94534-9639
Mailing address
480 Chadbourne Rd
Fairfield, CA 94534-9639
Phone (707) 330-8634
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122855 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Clinical | Current | Accepting new patients |
Locations
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 1
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": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1578239711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 CHADBOURNE RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945349639",
"telephone_number": "707-330-8634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 CHADBOURNE RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945349639",
"telephone_number": "707-429-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEOL",
"first_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-18",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "122855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.