Individual provider Active NPI

Kathryn Wood

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1689219420
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
91956 Issued in CA
Practice address
4610 Foothill Blvd
Oakland, CA 94601-4618
Phone
(781) 771-0129
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 009762 CT
Clinical Social Worker 1041C0700X 91956 CA Primary

Addresses

Primary practice location

4610 Foothill Blvd
Oakland, CA 94601-4618

Mailing address

1277 Bates Rd
Oakland, CA 94610-2536
Phone (781) 771-0129

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
I20201017000049 CA Practitioner - Clinical Social Worker 2264866375 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009762CTMDSocial Worker
91956CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Sep 8, 2020 Accepting new patients
Alameda Health System CurrentSince Sep 8, 2020 Accepting new patients
Alameda Health System Current Accepting new patients

Locations

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1689219420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 BATES RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102536",
            "telephone_number": "781-771-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 FOOTHILL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946014618",
            "telephone_number": "781-771-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "009762",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.