Active NPI
Shea Anderson
- Clinical Social Worker
- San Mateo, CA
National Provider Identifier
1689964991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27103
- Practice address
- 222 W 39TH Ave
SMMC- Pain Clinic
San Mateo, CA 94403-4364 - Phone
- (650) 573-2552
- Fax
- (650) 572-2839
- NPI assigned
- Apr 8, 2011
- Last updated
- Apr 8, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27103 | CA | Primary |
Addresses
Primary practice location
222 W 39TH Ave
SMMC- Pain Clinic
San Mateo, CA 94403-4364
Mailing address
222 West 39TH Ave
San Mateo Medical Center- Pain Clinic
San Mateo, CA 94403
Phone (650) 573-2552
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302220800000",
"number": "1689964991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 WEST 39TH AVE",
"address_2": "SAN MATEO MEDICAL CENTER- PAIN CLINIC",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "94403",
"telephone_number": "650-573-2552",
"fax_number": "650-572-2839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W 39TH AVE",
"address_2": "SMMC- PAIN CLINIC",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034364",
"telephone_number": "650-573-2552",
"fax_number": "650-572-2839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SHEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-08",
"last_updated": "2011-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "27103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.