Individual provider Active NPI

Eunice Fernandez, L.C.S.W.

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1669178240
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28952 Issued in CA
Practice address
2742 Burlingame Way
San Jose, CA 95121-1208
Phone
(831) 261-7746
NPI assigned
Feb 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28952 CA Primary

Addresses

Primary practice location

2742 Burlingame Way
San Jose, CA 95121-1208

Mailing address

2742 Burlingame Way
San Jose, CA 95121-1208
Phone (831) 261-7746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1669178240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 BURLINGAME WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211208",
            "telephone_number": "831-261-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2742 BURLINGAME WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211208",
            "telephone_number": "831-261-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "EUNICE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.