Individual provider Active NPI

Shamilla Byron, MSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1962776898
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28094 Issued in CA
Practice address
3301 E 12TH St
Suite 259
Oakland, CA 94601-3424
Phone
(510) 269-9030
NPI assigned
Feb 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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 28094 CA Primary

Addresses

Primary practice location

3301 E 12TH St
Suite 259
Oakland, CA 94601-3424

Mailing address

1515 Alice St
Apt. 19
Oakland, CA 94612-4160
Phone (301) 204-5241

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
I20250911004540 CA Practitioner - Clinical Social Worker 6608379946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28094CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Jul 29, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1962776898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 ALICE ST",
            "address_2": "APT. 19",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946124160",
            "telephone_number": "301-204-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E 12TH ST",
            "address_2": "SUITE 259",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013424",
            "telephone_number": "510-269-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRON",
        "first_name": "SHAMILLA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.