Individual provider Active NPI

Charles Gerould Chadwick, ASW

  • Social Worker
  • San Jose, CA
National Provider Identifier
1669020038
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW110223 Issued in CA
Practice address
4100 Moorpark Ave Ste 120
San Jose, CA 95117-1707
Phone
(408) 320-5960
NPI assigned
Aug 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW110223 CA Primary

Addresses

Primary practice location

4100 Moorpark Ave Ste 120
San Jose, CA 95117-1707

Mailing address

232 E Gish Rd
San Jose, CA 95112-4706
Phone (831) 425-8132

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
ASW110223CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1669020038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 E GISH RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124706",
            "telephone_number": "831-425-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MOORPARK AVE STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171707",
            "telephone_number": "408-320-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "CHARLES",
        "middle_name": "GEROULD",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW110223",
            "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 15, 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.