Active NPI
Matthew Luu, LCSW
- Clinical Social Worker
- San Pablo, CA
National Provider Identifier
1881736015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21092
- Practice address
- 2523 El Portal Dr
Ste 103
San Pablo, CA 94806-3305 - Phone
- (510) 374-7500
- Fax
- (510) 374-7504
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21092 | CA | Primary |
Addresses
Primary practice location
2523 El Portal Dr
Ste 103
San Pablo, CA 94806-3305
Mailing address
2523 El Portal Dr Ste 103
San Pablo, CA 94806-3305
Phone (510) 374-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1839 | Other | CA | MENTAL HEALTH SERVICES |
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": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881736015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2523 EL PORTAL DR STE 103",
"city": "SAN PABLO",
"state": "CA",
"postal_code": "948063305",
"telephone_number": "510-374-7500",
"fax_number": "510-374-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2523 EL PORTAL DR",
"address_2": "STE 103",
"city": "SAN PABLO",
"state": "CA",
"postal_code": "948063305",
"telephone_number": "510-374-7500",
"fax_number": "510-374-7504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUU",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "21092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH SERVICES",
"identifier": "1839",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Pablo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.