Desirae Perouz Walker, CADC-CAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

109916 Issued in CA

Practice address

310 Harbor Blvd BLDG E
Belmont, CA 94002-4018

Phone

(650) 802-6468

NPI assigned

Dec 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1588932248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 27TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944032496",
            "telephone_number": "650-430-9867",
            "fax_number": "650-355-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARBOR BLVD BLDG E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024018",
            "telephone_number": "650-802-6468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Quarry Rd Fl 3Rs",
            "address_purpose": "LOCATION",
            "city": "San Carlos",
            "state": "CA",
            "postal_code": "940706221",
            "country_code": "US",
            "telephone_number": "650-508-6745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "480 Manor Plz",
            "address_purpose": "LOCATION",
            "city": "Pacifica",
            "state": "CA",
            "postal_code": "940441839",
            "country_code": "US",
            "telephone_number": "650-355-8787 x142",
            "fax_number": "650-355-8780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DESIRAE",
        "middle_name": "PEROUZ",
        "credential": "CADC-CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "109916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED ADDICTION SPECIALIST INTERN (RASI)",
            "identifier": "RI-M1104291258",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "ASW-109916",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS",
            "identifier": "C05591518",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmiller@smcgov.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "310 Harbor Blvd Bldg E",
            "city": "Belmont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940024018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Belmont, CA
• Providers in Belmont, 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 Dec 12, 2023; 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.