Individual provider Active NPI

Machelle Pardue

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1750832937
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121370 Issued in CA
Practice address
1400 Parkmoor Ave
Suite 115
San Jose, CA 95126-3797
Phone
(408) 971-9822
NPI assigned
Oct 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 121370 CA Primary

Addresses

Primary practice location

1400 Parkmoor Ave
Suite 115
San Jose, CA 95126-3797

Mailing address

4082 Valeta St Unit 361
San Diego, CA 92110-5823
Phone (619) 609-4937

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

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1750832937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4082 VALETA ST UNIT 361",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105823",
            "telephone_number": "619-609-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PARKMOOR AVE",
            "address_2": "SUITE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263797",
            "telephone_number": "408-971-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDUE",
        "first_name": "MACHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.