Individual provider Active NPI

Lois Lane, LCSW

  • Clinical Social Worker
  • San Anselmo, CA
National Provider Identifier
1831202530
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS3963 Issued in CA
Practice address
412 Red Hill Ave
Suite #5
San Anselmo, CA 94960-2450
Phone
(415) 459-3342
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS3963 CA Primary

Addresses

Primary practice location

412 Red Hill Ave
Suite #5
San Anselmo, CA 94960-2450

Mailing address

412 Red Hill Ave
Suite #5
San Anselmo, CA 94960-2450
Phone (415) 459-3342

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
I20100924000487 CA Practitioner - Clinical Social Worker 0143346312 Practice locations: San Anselmo, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS3963CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831202530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 RED HILL AVE",
            "address_2": "SUITE #5",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602450",
            "telephone_number": "415-459-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 RED HILL AVE",
            "address_2": "SUITE #5",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602450",
            "telephone_number": "415-459-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LOIS",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS3963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

Verify at the official NPI Registry.