Active NPI
Kassandra Gibbs, LCSW 93147
- Clinical Social Worker
- Pittsburg, CA
National Provider Identifier
1912440934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 93147
- Practice address
- 47 Robinson Ave
Pittsburg, CA 94565-4842 - Phone
- (530) 524-1101
- NPI assigned
- Nov 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 93147 | CA | Primary |
Addresses
Primary practice location
47 Robinson Ave
Pittsburg, CA 94565-4842
Mailing address
47 Robinson Ave
Pittsburg, CA 94565-4842
Phone (530) 524-1101
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
| License | State | Type | Specialty |
|---|---|---|---|
| 93147 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- kassandragibbs@tdh.allscriptsdirect.net
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": "1479772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1912440934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 ROBINSON AVE",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945654842",
"telephone_number": "530-524-1101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 ROBINSON AVE",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945654842",
"telephone_number": "530-524-1101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "KASSANDRA",
"credential": "LCSW 93147",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-22",
"last_updated": "2021-06-02",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "93147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.