Individual provider Active NPI

Daniel J. Bruce, L.C.S.W.

  • Clinical Social Worker
  • Modesto, CA
National Provider Identifier
1891889366
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS13251 Issued in CA
Practice address
3300 Tully Rd
Suite C-1
Modesto, CA 95350-0836
Phone
(209) 529-2084
Fax
(209) 529-2282
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 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 LCS13251 CA Primary

Addresses

Primary practice location

3300 Tully Rd
Suite C-1
Modesto, CA 95350-0836

Mailing address

3300 Tully Rd
Suite C-1
Modesto, CA 95350-0836
Phone (209) 529-2084

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
I20120120000807 CA Practitioner - Clinical Social Worker 2163699885 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3300 Tully Rd
C1
Modesto, CA 95350-0849
Phone (209) 529-2084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13251CAMDProfessional Counselor
LCS13251CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Israels, Marriage Family Therapist, Inc. PastSince Apr 26, 2020 Accepting new patients

Organizations & group practices 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1891889366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 TULLY RD",
            "address_2": "SUITE C-1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500836",
            "telephone_number": "209-529-2084",
            "fax_number": "209-529-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TULLY RD",
            "address_2": "SUITE C-1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500836",
            "telephone_number": "209-529-2084",
            "fax_number": "209-529-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "DANIEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.