Individual provider Active NPI

Debra Michelle Gionet, LCSW 21514

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1679767487
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21514 Issued in CA
Practice address
3880 S Bascom Ave
Suite 202
San Jose, CA 95124-2674
Phone
(408) 450-1307
Fax
(408) 371-9193
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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 21514 CA Primary

Addresses

Primary practice location

3880 S Bascom Ave
Suite 202
San Jose, CA 95124-2674

Mailing address

3880 S Bascom Ave
Suite 202
San Jose, CA 95124-2674
Phone (408) 450-1307

Other names 1

  • Debra Michelle Delizonna Former name

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
21514CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1679767487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE",
            "address_2": "SUITE 202",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242674",
            "telephone_number": "408-450-1307",
            "fax_number": "408-371-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE",
            "address_2": "SUITE 202",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242674",
            "telephone_number": "408-450-1307",
            "fax_number": "408-371-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIONET",
        "first_name": "DEBRA",
        "middle_name": "MICHELLE",
        "credential": "LCSW 21514",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "DELIZONNA",
            "middle_name": "MICHELLE",
            "credential": "LCSW 21514",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 30, 2009; 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.