Individual provider Active NPI

Rachel Diane Dacosta, LCSW

  • Clinical Social Worker
  • Alameda, CA
National Provider Identifier
1821124389
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29072 Issued in CA
Practice address
2325 Clement Ave
Alameda, CA 94501-7063
Phone
(510) 629-6300
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 29072 CA Primary

Addresses

Primary practice location

2325 Clement Ave
Alameda, CA 94501-7063

Mailing address

3248 Briggs Ave Apt C
Alameda, CA 94501-4848
Phone (415) 359-4072

Other practice location 1

433 Callan Ave Ste 309
San Leandro, CA 94577-4641
Phone (415) 359-4072

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
29072CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1821124389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 BRIGGS AVE APT C",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014848",
            "telephone_number": "415-359-4072",
            "fax_number": "510-995-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 CLEMENT AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945017063",
            "telephone_number": "510-629-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 Callan Ave Ste 309",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774641",
            "country_code": "US",
            "telephone_number": "415-359-4072",
            "fax_number": "510-995-8270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "RACHEL",
        "middle_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.