Active NPI
Ada Jane Bravo
- Social Worker
- San Leandro, CA
National Provider Identifier
1861200628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 128368
- Practice address
- 777 Davis St
San Leandro, CA 94577-6923 - Phone
- (510) 839-3800
- NPI assigned
- Dec 26, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | 128368 | CA | Primary |
Addresses
Primary practice location
777 Davis St
San Leandro, CA 94577-6923
Mailing address
777 Davis St
San Leandro, CA 94577-6923
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1861200628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 DAVIS ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945776923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 DAVIS ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945776923",
"telephone_number": "510-839-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "ADA",
"middle_name": "JANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-26",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "128368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.