Active NPI
Itzia Veronica Cruz
- Clinical Social Worker
- Hayward, CA
National Provider Identifier
1639533987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114949
- Practice address
- 2575 Depot Rd
Hayward, CA 94545-2341 - Phone
- (510) 784-5874
- NPI assigned
- Apr 12, 2016
- 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 | 114949 | CA | Primary |
Addresses
Primary practice location
2575 Depot Rd
Hayward, CA 94545-2341
Mailing address
4209 Green Knoll Rd
Salida, CA 95368-9701
Phone (209) 606-6297
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 |
|---|---|---|---|
| 114949 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Services, Inc | Current | Accepting new patients | |
| Victor Community Support Services, Inc. | Past | Accepting new patients |
Locations
2575 Depot Rd
Hayward, CA 94545
Phone (510) 784-5874
Organizations & group practices 2
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.
-
dba Cronin House
- Substance Abuse Rehabilitation Facility
- Hayward, CA
- NPI 1336325737
-
- Adolescent and Children Mental Health Clinic/Center
- Stockton, CA
- NPI 1932251980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1639533987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 GREEN KNOLL RD",
"city": "SALIDA",
"state": "CA",
"postal_code": "953689701",
"telephone_number": "209-606-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2575 DEPOT RD",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945452341",
"telephone_number": "510-784-5874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "ITZIA",
"middle_name": "VERONICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "114949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.