Active NPI
Shirley Taboada, LCSW
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1669697785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW76661
- Practice address
- 160 E Virginia Street
#280
San Jose, CA 95112 - Phone
- (408) 287-6200
- Fax
- (408) 998-1535
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | LCSW76661 | CA | Primary |
Addresses
Primary practice location
160 E Virginia Street
#280
San Jose, CA 95112
Mailing address
160 E Virginia Street
#280
San Jose, CA 95112
Phone (408) 287-6200
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200108002728 | CA | Order and Referring Only - Clinical Social Worker | 9234487257 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW76661 | CA | MD | Clinical Social Worker |
| 76661 | CA | MD | Ambulatory Care Pharmacist |
Interoperability endpoints
- shirley.toboada.p1@direct.gardnerfamily.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1669697785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 E VIRGINIA STREET",
"address_2": "#280",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95112",
"telephone_number": "408-287-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E VIRGINIA STREET",
"address_2": "#280",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95112",
"telephone_number": "408-287-6200",
"fax_number": "408-998-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABOADA",
"first_name": "SHIRLEY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW76661",
"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 Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.