Active NPI
Julia Wallace
- Clinical Social Worker
- San Francisco, CA
National Provider Identifier
1780126979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 25077
- Practice address
- 110 Gough St Ste 402
San Francisco, CA 94102-5971 - Phone
- (510) 290-9359
- NPI assigned
- Nov 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 25077 | CA | Primary |
Addresses
Primary practice location
110 Gough St Ste 402
San Francisco, CA 94102-5971
Mailing address
110 Gough St
Suite 402
San Francisco, CA 94102-5945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2026 through Jul 1, 2028
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1251 Masonic Ave
San Francisco, CA 94117-2916
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1780126979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 GOUGH ST",
"address_2": "SUITE 402",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941025945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 GOUGH ST STE 402",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941025971",
"telephone_number": "510-290-9359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "JULIA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-06",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "25077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- 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.