Individual provider Active NPI

Amber Lee Mayfield

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1679618086
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW76562 Issued in CA
Practice address
280 17TH St
Oakland, CA 94612-4124
Phone
(510) 238-5020
Fax
(510) 261-3584
NPI assigned
Feb 21, 2007
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X LCSW76562 CA Primary

Addresses

Primary practice location

280 17TH St
Oakland, CA 94612-4124

Mailing address

280 17TH St
Oakland, CA 94612-4124
Phone (510) 238-5020

Other identifiers 2

IdentifierTypeStateIssuer
ASW28529OtherCABOARD OF BEHAVIORAL SCIENCES
LCSW76562OtherCABOARD OF BEHAVIORAL SCIENCES

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
I20210817001881 CA Practitioner - Clinical Social Worker 3971908773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1080 Marina Village Pkwy
Alameda, CA 94501-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW76562CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Jan 26, 2025 Accepting new patients
Telecare Corporation Current Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

280 17th St
Oakland, CA 94612
Phone (510) 238-5020

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1679618086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 17TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946124124",
            "telephone_number": "510-238-5020",
            "fax_number": "510-261-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 17TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946124124",
            "telephone_number": "510-238-5020",
            "fax_number": "510-261-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "AMBER",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW76562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "ASW28529",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LCSW76562",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.