Active NPI
Nancy D Colvin, LCSW
- Clinical Social Worker
- Petaluma, CA
National Provider Identifier
1891028163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS16435
- Practice address
- 1301 Southpoint Blvd
Petaluma, CA 94954-6858 - Phone
- (707) 559-7500
- Fax
- (707) 559-7510
- NPI assigned
- Sep 17, 2009
- Last updated
- Sep 17, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS16435 | CA | Primary |
Addresses
Primary practice location
1301 Southpoint Blvd
Petaluma, CA 94954-6858
Mailing address
1301 Southpoint Blvd
Petaluma, CA 94954-6858
Phone (707) 559-7500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS16435 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253145600000",
"number": "1891028163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 SOUTHPOINT BLVD",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949546858",
"telephone_number": "707-559-7500",
"fax_number": "707-559-7510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 SOUTHPOINT BLVD",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949546858",
"telephone_number": "707-559-7500",
"fax_number": "707-559-7510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLVIN",
"first_name": "NANCY",
"middle_name": "D",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-17",
"last_updated": "2009-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS16435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.