Active NPI
Elisabeth Ann Smith, ACSW
- Clinical Social Worker
- Ceres, CA
National Provider Identifier
1891199055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 72608
- Practice address
- 2760 3Rd St
Ceres, CA 95307-3235 - Phone
- (866) 682-4842
- Fax
- (209) 556-5095
- NPI assigned
- Oct 17, 2014
- 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 | 72608 | CA | Primary |
Addresses
Primary practice location
2760 3Rd St
Ceres, CA 95307-3235
Mailing address
737 W Childs Ave
Merced, CA 95341-6805
Phone (866) 682-4842
Other practice location 1
1404 Havasu Dr
Modesto, CA 95355-5608
Phone (209) 521-1234
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566518400000",
"number": "1891199055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 W CHILDS AVE",
"city": "MERCED",
"state": "CA",
"postal_code": "953416805",
"telephone_number": "866-682-4842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2760 3RD ST",
"city": "CERES",
"state": "CA",
"postal_code": "953073235",
"telephone_number": "866-682-4842",
"fax_number": "209-556-5095"
}
],
"practiceLocations": [
{
"address_1": "1404 Havasu Dr",
"address_purpose": "LOCATION",
"city": "Modesto",
"state": "CA",
"postal_code": "953555608",
"country_code": "US",
"telephone_number": "209-521-1234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "ELISABETH",
"middle_name": "ANN",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2019-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "72608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ceres, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.