Active NPI
Judy L Passanante, LCSW
- Clinical Social Worker
- Fremont, CA
National Provider Identifier
1811083041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW14074
- Practice address
- 39650 Liberty St
Suite 310
Fremont, CA 94538-2223 - Phone
- (510) 498-2890
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
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 | LCSW14074 | CA | Primary |
Addresses
Primary practice location
39650 Liberty St
Suite 310
Fremont, CA 94538-2223
Mailing address
2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-6203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCSW14074 | Other | CA | CA LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW14074 | CA | MD | Clinical Social Worker |
| 14074 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377734400000",
"number": "1811083041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 W. EL CAMINO REAL",
"address_2": "2ND FLOOR",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940406203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39650 LIBERTY ST",
"address_2": "SUITE 310",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382223",
"telephone_number": "510-498-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSANANTE",
"first_name": "JUDY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2013-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW14074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA LICENSE",
"identifier": "LCSW14074",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.