Individual provider Active NPI

Claudius Johnson, LCSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1770738122
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS25062 Issued in CA
Practice address
614 Grand Ave
Ste 203
Oakland, CA 94610-3554
Phone
(510) 433-0244
Fax
(510) 380-6525
NPI assigned
Nov 27, 2008
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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 LCS25062 CA Primary

Addresses

Primary practice location

614 Grand Ave
Ste 203
Oakland, CA 94610-3554

Mailing address

614 Grand Ave
Ste 203
Oakland, CA 94610-3554
Phone (510) 433-0244

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
I20091124000116 CA Practitioner - Clinical Social Worker 0244379618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

614 Grand Ave
Suite 324
Oakland, CA 94610-3563
Phone (510) 879-7402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25062CAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ntu Wellness Center CurrentSince Sep 20, 2023 Accepting new patients

Locations

614 Grand Ave
Ste 324
Oakland, CA 94610
Phone (510) 210-1024

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1227744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1770738122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 GRAND AVE",
            "address_2": "STE 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103554",
            "telephone_number": "510-433-0244",
            "fax_number": "510-380-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 GRAND AVE",
            "address_2": "STE 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103554",
            "telephone_number": "510-433-0244",
            "fax_number": "510-380-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CLAUDIUS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-27",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS25062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.