Individual provider Active NPI

Mary Triulzi

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1861687246
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW85182 Issued in CA
Practice address
160 E Virginia St Ste 100
San Jose, CA 95112-5865
Phone
(408) 938-2113
Fax
(408) 579-6143
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 LCSW85182 CA Primary

Addresses

Primary practice location

160 E Virginia St Ste 100
San Jose, CA 95112-5865

Mailing address

160 E Virginia St Ste 100
San Jose, CA 95112-5865
Phone (408) 938-2113

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
I20250106002789 CA Practitioner - Clinical Social Worker 3577091487 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW85182CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Family Health Network, Inc. CurrentSince Jan 15, 2025 Accepting new patients
Gardner Family Health Network Inc CurrentSince Jan 15, 2025 Accepting new patients
Clinical and Support Options Past Accepting new patients

Locations

160 E Virginia St
Ste 100
San Jose, CA 95112
Phone (408) 918-2618

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1861687246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125865",
            "telephone_number": "408-938-2113",
            "fax_number": "408-579-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125865",
            "telephone_number": "408-938-2113",
            "fax_number": "408-579-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIULZI",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW85182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.