Individual provider Active NPI

Douglas Weil

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1659832186
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113585 Issued in CA
Practice address
401 Roland Way
Oakland, CA 94621-2034
Phone
(510) 839-3800
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113585 CA Primary
Mental Health Counselor 101YM0800X
Case Management Agency 251B00000X CA

Addresses

Primary practice location

401 Roland Way
Oakland, CA 94621-2034

Mailing address

5714 Gaskill St
Oakland, CA 94608-2716
Phone (510) 289-9633

Other identifiers 1

IdentifierTypeStateIssuer
101YM0800XMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250311003833 CA Practitioner - Clinical Social Worker 3779004338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of SonomaGroup PAC ID 4688658651, 28 clinicians

Practice addresses (Care Compare)

2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone (707) 565-4861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113585CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sonoma Current Accepting new patients
County of Sonoma CurrentSince Feb 5, 2025 Accepting new patients
County of Sonoma CurrentSince Feb 5, 2025 Accepting new patients

Locations

1450 Neotomas Ave
Ste 200
Santa Rosa, CA 95405
Phone (707) 565-4131

2225 Challenger Way
Santa Rosa, CA 95407
Phone (707) 565-4101

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1659832186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 GASKILL ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082716",
            "telephone_number": "510-289-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ROLAND WAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946212034",
            "telephone_number": "510-839-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIL",
        "first_name": "DOUGLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113585",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.