Individual provider Active NPI

Ikema S. Ross, MSSW, LCSW

  • Social Worker
  • Fairfield, CA
National Provider Identifier
1942749064
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
116894 Issued in CA
Practice address
744 Empire St Ste 120
Fairfield, CA 94533-5550
Phone
(415) 815-0035
NPI assigned
Feb 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 116894 CA Primary

Addresses

Primary practice location

744 Empire St Ste 120
Fairfield, CA 94533-5550

Mailing address

744 Empire St Ste 120
Fairfield, CA 94533-5550
Phone (415) 815-0035

Other practice location 1

1840 Capitol St Ste B
Vallejo, CA 94590-5721
Phone (415) 815-0035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20250528001162 CA Practitioner - Clinical Social Worker 6901325448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Felton Institute Current Accepting new patients
Felton Institute CurrentSince Apr 23, 2025 Accepting new patients
Felton Institute CurrentSince Apr 23, 2025 Accepting new patients
Felton Institute CurrentSince Apr 23, 2025 Accepting new patients
Felton Institute Past Accepting new patients
Southern California Health & Rehabilitation Program Past Accepting new patients
Felton Institute PastSince Feb 2, 2025 Accepting new patients

Locations

1005 Atlantic Ave
Alameda, CA 94501
Phone (510) 318-6100

744 Empire St
Ste 120
Fairfield, CA 94533
Phone (415) 412-1640

1814 Franklin St
Oakland, CA 94612
Phone (510) 318-6100

6221 Geary Blvd
San Francisco, CA 94121
Phone (415) 251-5770

1108 S El Camino Real
San Mateo, CA 94402
Phone (650) 458-0026

361 3rd St
Ste B
San Rafael, CA 94901
Phone (415) 747-8178

Organizations & group practices 7

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": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1942749064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 EMPIRE ST STE 120",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335550",
            "telephone_number": "415-815-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 EMPIRE ST STE 120",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335550",
            "telephone_number": "415-815-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Capitol St Ste B",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945905721",
            "country_code": "US",
            "telephone_number": "415-815-0035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "IKEMA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "MSSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "116894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.