Individual provider Active NPI

Ngoc Loi, LCSW

  • Clinical Social Worker
  • San Rafael, CA
National Provider Identifier
1790802445
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW63571 Issued in CA
Practice address
3270 Kerner Blvd
Suite B
San Rafael, CA 94901-4840
Phone
(415) 473-2741
Fax
(415) 473-3850
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counselor 101Y00000X
Clinical Social Worker 1041C0700X LCSW63571 CA Primary

Addresses

Primary practice location

3270 Kerner Blvd
Suite B
San Rafael, CA 94901-4840

Mailing address

3270 Kerner Blvd
Suite B
San Rafael, CA 94901-4840
Phone (415) 473-2741

Other identifiers 2

IdentifierTypeStateIssuer
11262OtherSFGH INTERNAL USE ONLY
11262OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER

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
I20141222000559 CA Practitioner - Clinical Social Worker 8022331107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MarinGroup PAC ID 1153225065, 19 clinicians

Practice addresses (Care Compare)

20 N San Pedro Rd
San Rafael, CA 94903-4188

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 499-6835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW63571CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marin CurrentSince Sep 18, 2014 Accepting new patients
County of Marin CurrentSince Sep 18, 2014 Accepting new patients

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

3270 Kerner Blvd
Ste B
San Rafael, CA 94901
Phone (415) 473-2100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1790802445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 KERNER BLVD",
            "address_2": "SUITE B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-2741",
            "fax_number": "415-473-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 KERNER BLVD",
            "address_2": "SUITE B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-2741",
            "fax_number": "415-473-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOI",
        "first_name": "NGOC",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW63571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "11262",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "11262",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.