Individual provider Active NPI

Paul K. Sorbo

  • Clinical Social Worker
  • San Mateo, CA
National Provider Identifier
1912025412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS8488 Issued in CA
Practice address
225 37TH Ave
San Mateo, CA 94403-4324
Phone
(650) 573-2020
Fax
(650) 573-2841
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS8488 CA Primary

Addresses

Primary practice location

225 37TH Ave
San Mateo, CA 94403-4324

Mailing address

225 37TH Ave
San Mateo, CA 94403-4324
Phone (650) 573-2020

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

LicenseStateTypeSpecialty
LCS8488CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912025412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 37TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034324",
            "telephone_number": "650-573-2020",
            "fax_number": "650-573-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 37TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034324",
            "telephone_number": "650-573-2020",
            "fax_number": "650-573-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORBO",
        "first_name": "PAUL",
        "middle_name": "K.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS8488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.