Active NPI
Jodi D Vanderpol, LICSW
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1639224348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113131
- Practice address
- 2625 Zanker Rd
San Jose, CA 95134-2130 - Phone
- (408) 325-5155
- Fax
- (888) 842-1467
- NPI assigned
- Jan 24, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 113131 | MA | Primary |
Addresses
Primary practice location
2625 Zanker Rd
San Jose, CA 95134-2130
Mailing address
1643 27TH Ave
Oakland, CA 94601-1611
Phone (408) 325-5155
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113131 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1639224348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 27TH AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946011611",
"telephone_number": "408-325-5155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 ZANKER RD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951342130",
"telephone_number": "408-325-5155",
"fax_number": "888-842-1467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERPOL",
"first_name": "JODI",
"middle_name": "D",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "113131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.