Active NPI
Howard Vergara Mateo
- Clinical Social Worker
- Hillsboro, OR
National Provider Identifier
1730963257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 150.109176
- Practice address
- 1925 NE Stucki Ave Unit 300
Hillsboro, OR 97006-6945 - Phone
- (503) 906-5000
- NPI assigned
- Aug 24, 2023
- Sex
- Male
- 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 | 150.109176 | IL | Primary |
Addresses
Primary practice location
1925 NE Stucki Ave Unit 300
Hillsboro, OR 97006-6945
Mailing address
12567 SW 134TH Ave
Portland, OR 97223-4719
Phone (808) 205-1483
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150.109176 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1730963257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12567 SW 134TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972234719",
"telephone_number": "808-205-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 NE STUCKI AVE UNIT 300",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "970066945",
"telephone_number": "503-906-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEO",
"first_name": "HOWARD",
"middle_name": "VERGARA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "150.109176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.