Individual provider Active NPI

Juliette Kelley, LCSW

  • Clinical Social Worker
  • Pleasant Hill, CA
National Provider Identifier
1851574479
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
72491 Issued in CA
Practice address
399 Taylor Blvd Ste 210
Pleasant Hill, CA 94523-2287
Phone
(925) 325-1427
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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 72491 CA Primary

Addresses

Primary practice location

399 Taylor Blvd Ste 210
Pleasant Hill, CA 94523-2287

Mailing address

399 Taylor Blvd Ste 210
Pleasant Hill, CA 94523-2287
Phone (925) 325-1427

Other practice location 1

1000 Ward St
Martinez, CA 94553-1360
Phone (925) 348-3433

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
I20170125000072 CA Practitioner - Clinical Social Worker 7911289053 Practice locations: Pittsburg, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

325 Cumberland St
Suite a
Pittsburg, CA 94565-2205
Phone (925) 325-1427

399 Taylor Blvd
Suite 210
Pleasant Hill, CA 94523-2287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1851574479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 TAYLOR BLVD STE 210",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232287",
            "telephone_number": "925-325-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 TAYLOR BLVD STE 210",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232287",
            "telephone_number": "925-325-1427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Ward St",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "CA",
            "postal_code": "945531360",
            "country_code": "US",
            "telephone_number": "925-348-3433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JULIETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "72491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.