Individual provider Active NPI

Susan H Farabee

  • Social Worker
  • San Mateo, CA
National Provider Identifier
1619001260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW23621 Issued in CA
Practice address
150 W 20TH Ave
San Mateo, CA 94403-1341
Phone
(650) 573-3629
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW23621 CA Primary

Addresses

Primary practice location

150 W 20TH Ave
San Mateo, CA 94403-1341

Mailing address

150 W 20TH Ave
San Mateo, CA 94403-1341
Phone (650) 573-3629

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
LCSW23621CAMDSocial Worker
23621CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Psychological Services, Inc. CurrentSince Nov 16, 2021 Accepting new patients
County of San Mateo Past Accepting new patients
San Mateo County Health Department Past Accepting new patients

Locations

39180 Liberty St
Ste 205
Fremont, CA 94538
Phone (510) 439-0657

Organizations & group practices 3

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619001260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W 20TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031341",
            "telephone_number": "650-573-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W 20TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031341",
            "telephone_number": "650-573-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARABEE",
        "first_name": "SUSAN",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW23621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.