Active NPI
Robin Wilson, LCSW #73335
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1821260480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 73335
- Practice address
- 871 Enborg CT Unit 100
San Jose, CA 95128-2645 - Phone
- (408) 885-6482
- Fax
- (408) 885-5376
- NPI assigned
- Mar 24, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | # NA201302 | CA | |
| Clinical Social Worker | 1041C0700X | ASW #23491 | CA | |
| Clinical Social Worker | 1041C0700X | 73335 | CA | Primary |
Addresses
Primary practice location
871 Enborg CT Unit 100
San Jose, CA 95128-2645
Mailing address
871 Enborg CT Unit 100
San Jose, CA 95128-2645
Phone (408) 793-2425
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
| License | State | Type | Specialty |
|---|---|---|---|
| # NA201302 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| ASW #23491 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1821260480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "871 ENBORG CT UNIT 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282645",
"telephone_number": "408-793-2425",
"fax_number": "408-448-1815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 ENBORG CT UNIT 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282645",
"telephone_number": "408-885-6482",
"fax_number": "408-885-5376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBIN",
"credential": "LCSW #73335",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-24",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "# NA201302",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW #23491",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "73335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.