Active NPI
Virginia Ballantyne
- Clinical Social Worker
- San Jose, CA
National Provider Identifier
1932509064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW98267
- Practice address
- 151 W Mission St
San Jose, CA 95110-1713 - Phone
- (408) 535-4260
- Fax
- (408) 280-7201
- NPI assigned
- Aug 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW67416 | CA | |
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | LCSW98267 | CA | Primary |
Addresses
Primary practice location
151 W Mission St
San Jose, CA 95110-1713
Mailing address
151 W Mission St
San Jose, CA 95110-1713
Phone (408) 535-4260
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 |
|---|---|---|---|
| ASW67416 | CA | MD | Clinical Social Worker |
| LCSW98267 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1932509064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 W MISSION ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951101713",
"telephone_number": "408-535-4260",
"fax_number": "408-280-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 W MISSION ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951101713",
"telephone_number": "408-535-4260",
"fax_number": "408-280-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLANTYNE",
"first_name": "VIRGINIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-26",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW67416",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW98267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.