Individual provider Active NPI

Rachel Michelle Maccratic, J.D., M.S.W.

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1912351685
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121395 Issued in CA
Practice address
629 Oakland Ave
Oakland, CA 94611-4567
Phone
(510) 804-7902
Fax
(510) 569-4589
NPI assigned
Apr 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Case Manager/Care Coordinator 171M00000X 283283 CA
Clinical Social Worker 1041C0700X 121395 CA Primary

Addresses

Primary practice location

629 Oakland Ave
Oakland, CA 94611-4567

Mailing address

777 14TH St
San Francisco, CA 94114-1322
Phone (415) 302-9346

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
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
121395CAMDMarriage & Family Therapist
283283CAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1912351685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 14TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141322",
            "telephone_number": "415-302-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 OAKLAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114567",
            "telephone_number": "510-804-7902",
            "fax_number": "510-569-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCRATIC",
        "first_name": "RACHEL",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "J.D., M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "283283",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.