Individual provider Active NPI

Mimi Lee

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1942363494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS18673 Issued in CA
Practice address
4141 Geary Blvd FL 3
San Francisco, CA 94118-3111
Phone
(415) 833-2292
NPI assigned
Dec 18, 2006
Sex
Female
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 LCS18673 CA Primary

Addresses

Primary practice location

4141 Geary Blvd FL 3
San Francisco, CA 94118-3111

Mailing address

4141 Geary Blvd FL 3
San Francisco, CA 94118-3111
Phone (415) 833-2292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150401002703 CA Practitioner - Clinical Social Worker 6204153117 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS18673CAMDClinical Social Worker
18673CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Feb 1, 2015 Accepting new patients
Permanente Medical Group Inc CurrentSince Feb 1, 2015 Accepting new patients
City & County of San Francisco CurrentSince May 23, 2020 Accepting new patients
City & County of San Francisco Current Accepting new patients
City and County of San Francisco CurrentSince May 23, 2020 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

375 Laguna Honda Blvd
San Francisco, CA 94116
Phone (415) 759-2300

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

4141 Geary Blvd
Fl 3
San Francisco, CA 94118
Phone (415) 833-2292

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 5

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942363494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 GEARY BLVD FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183111",
            "telephone_number": "415-833-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 GEARY BLVD FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183111",
            "telephone_number": "415-833-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.