Active NPI
Sydne K Bortel, MSW
- Clinical Social Worker
- San Rafael, CA
National Provider Identifier
1679629208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS4624
- Practice address
- 711 D St
San Rafael, CA 94901-3707 - Phone
- (415) 435-3988
- Fax
- (415) 435-8445
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS4624 | CA | Primary |
Addresses
Primary practice location
711 D St
San Rafael, CA 94901-3707
Mailing address
8 Corte Palos Verdes
Tiburon, CA 94920
Phone (415) 435-3988
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCS4624 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679629208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 CORTE PALOS VERDES",
"city": "TIBURON",
"state": "CA",
"postal_code": "94920",
"telephone_number": "415-435-3988",
"fax_number": "415-435-8445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 D ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013707",
"telephone_number": "415-435-3988",
"fax_number": "415-435-8445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORTEL",
"first_name": "SYDNE",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS4624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.