Individual provider Active NPI

Nancy Fernandez, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1710140355
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28916 Issued in CA
Practice address
55 E Julian St
San Jose, CA 95112-4007
Phone
(408) 918-2600
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 28916 CA Primary

Addresses

Primary practice location

55 E Julian St
San Jose, CA 95112-4007

Mailing address

55 E Julian St
San Jose, CA 95112-4007
Phone (408) 918-2600

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
I20160617000633 CA Practitioner - Clinical Social Worker 5698066850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Para la GenteGroup PAC ID 8729984729, 41 clinicians

Practice addresses (Care Compare)

195 Aviation Way
Suite 200
Watsonville, CA 95076-2059

204 E Beach St
Watsonville, CA 95076-4809
Phone (831) 728-8250

45 Neilson St
Watsonville, CA 95076-2468
Phone (831) 728-8250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince May 23, 2016 Accepting new patients
Salud Para la Gente CurrentSince May 23, 2016 Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

Organizations & group practices 2

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1710140355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JULIAN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124007",
            "telephone_number": "408-918-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E JULIAN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124007",
            "telephone_number": "408-918-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "NANCY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.