Active NPI
Judy L Rose, LCSW
- Clinical Social Worker
- Alameda, CA
National Provider Identifier
1639228588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW24551
- Practice address
- 2515 Santa Clara Ave Ste 106
Alameda, CA 94501-4667 - Phone
- (510) 842-8647
- Fax
- (510) 866-2274
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | LCSW24551 | CA | Primary |
Addresses
Primary practice location
2515 Santa Clara Ave Ste 106
Alameda, CA 94501-4667
Mailing address
4635 Camden St
Oakland, CA 94619-2639
Phone (415) 887-8273
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 |
|---|---|---|---|
| LCSW24551 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1639228588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 CAMDEN ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946192639",
"telephone_number": "415-887-8273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2515 SANTA CLARA AVE STE 106",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014667",
"telephone_number": "510-842-8647",
"fax_number": "510-866-2274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JUDY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW24551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.