Active NPI
Erica Marie Gomes, LCSW
- Social Worker
- Oakland, CA
National Provider Identifier
1699046573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24370
- Practice address
- 1450 Fruitvale Avenue
2ND Floor Suite E
Oakland, CA 94601 - Phone
- (510) 535-6200
- Fax
- (415) 431-3178
- NPI assigned
- Jan 24, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCS 24370 | CA | |
| Social Worker | 104100000X | 24370 | Primary |
Addresses
Primary practice location
1450 Fruitvale Avenue
2ND Floor Suite E
Oakland, CA 94601
Mailing address
P.O. Box 22210
Oakland, CA 94623
Phone (510) 535-2965
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160617001086 | CA | Order and Referring Only - Clinical Social Worker | 5395036560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 24370 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377216000000",
"number": "1699046573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 22210",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94623",
"telephone_number": "510-535-2965",
"fax_number": "510-535-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 FRUITVALE AVENUE",
"address_2": "2ND FLOOR SUITE E",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94601",
"telephone_number": "510-535-6200",
"fax_number": "415-431-3178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMES",
"first_name": "ERICA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-24",
"last_updated": "2013-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCS 24370",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "24370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.