Active NPI
David Zajanc
- Clinical Social Worker
- Eureka, CA
National Provider Identifier
1780085043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 89178
- Practice address
- 3015 Hubbard LN
Eureka, CA 95501-4802 - Phone
- (707) 273-8833
- NPI assigned
- Sep 5, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | ASW66588 | CA | |
| Clinical Social Worker | 1041C0700X | 89178 | CA | Primary |
Addresses
Primary practice location
3015 Hubbard LN
Eureka, CA 95501-4802
Mailing address
3015 Hubbard LN
Eureka, CA 95501-4802
Phone (707) 273-8833
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 |
|---|---|---|---|---|
| I20220805000447 | CA | Practitioner - Clinical Social Worker | 6709268840 | Practice locations: Eureka, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3015 Hubbard LN
Suite 3
Eureka, CA 95501-4803
Phone (707) 273-8833
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW66588 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651363200000",
"number": "1780085043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 HUBBARD LN",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014802",
"telephone_number": "707-273-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 HUBBARD LN",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014802",
"telephone_number": "707-273-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAJANC",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-05",
"last_updated": "2022-05-01",
"certification_date": "2022-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "ASW66588",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "89178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.