Theresa Matich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

79930 Issued in CA

Practice address

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Phone

(323) 968-6182

Fax

(833) 419-0181

NPI assigned

Jul 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1962844563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-968-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "323-968-6182",
            "fax_number": "833-419-0181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 Balsam St",
            "address_purpose": "LOCATION",
            "city": "Calimesa",
            "state": "CA",
            "postal_code": "923204912",
            "country_code": "US",
            "telephone_number": "951-333-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATICH",
        "first_name": "THERESA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Hunt Mather, OTR
• Noelle Mathews, LMFT
• Ankur Mathur, DO
• Mati Custom Chiropractic Corporation
• Ledia Mati
• Celso Matos
• Tara Monique Matthews
• Anna Mattson
• Gabrielle Mattson
• Maung Patel Oms Partnership

• Clinical Social Worker in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.