Individual provider Active NPI

Jose Manuel Gomez Tlacoxolal, ACSW

  • Clinical Social Worker
  • Palo Alto, CA
National Provider Identifier
1659996494
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
510 Sand Hill Rd
Palo Alto, CA 94304-2001
Phone
(650) 470-6004
NPI assigned
Jun 8, 2020
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 97149 CA
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

510 Sand Hill Rd
Palo Alto, CA 94304-2001

Mailing address

765 Montague Expy Apt 423
Milpitas, CA 95035-8867
Phone (831) 214-6289

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

LicenseStateTypeSpecialty
97149CAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1659996494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 MONTAGUE EXPY APT 423",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358867",
            "telephone_number": "831-214-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SAND HILL RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042001",
            "telephone_number": "650-470-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ TLACOXOLAL",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "97149",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.