Scott Bloom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24339 Issued in CA

Practice address

409 Jackson St
Hayward, CA 94544-1530

Phone

(415) 308-4701

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1902946924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "415-308-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "415-308-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "568 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946121618",
            "country_code": "US",
            "telephone_number": "510-278-7837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SCOTT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada Blanshard
• Kelly Blaser
• Theresa Blaylock, MPA
• Victoria Blazquez
• Nakeisha Bledsoe, SUCRC
• Michelle Hannah Bloomberg
• Kyle Bloomster
• Robert L. Blum, MD
• Brittney Adwoa Boateng
• Barton Bodrian

• Clinical Social Worker in Hayward, CA
• Providers in Hayward, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.