Individual provider Active NPI

Sebastin Zachery Weaver

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1790379980
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW99571 Issued in CA
Practice address
614 Grand Ave # 203
Oakland, CA 94610-3554
Phone
(510) 433-0244
NPI assigned
Feb 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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 ASW99571 CA Primary

Addresses

Primary practice location

614 Grand Ave # 203
Oakland, CA 94610-3554

Mailing address

614 Grand Ave # 203
Oakland, CA 94610-3554

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

LicenseStateTypeSpecialty
ASW99571CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1790379980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 GRAND AVE # 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 GRAND AVE # 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103554",
            "telephone_number": "510-433-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SEBASTIN",
        "middle_name": "ZACHERY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW99571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.