Individual provider Active NPI

Sierra Dator, LSCW

  • Clinical Social Worker
  • Petaluma, CA
National Provider Identifier
1891827424
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS23317 Issued in CA
Practice address
134 Howard St
Petaluma, CA 94952-2922
Phone
(707) 478-4351
NPI assigned
Mar 9, 2007
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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 LCS23317 CA Primary

Addresses

Primary practice location

134 Howard St
Petaluma, CA 94952-2922

Mailing address

134 Howard St
Petaluma, CA 94952-2922

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
I20120412000728 CA Practitioner - Clinical Social Worker 8022279314 Practice locations: Petaluma, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

134 Howard St
Petaluma, CA 94952-2922
Phone (707) 478-4351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS23317CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1891827424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 HOWARD ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HOWARD ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522922",
            "telephone_number": "707-478-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATOR",
        "first_name": "SIERRA",
        "credential": "LSCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.