MS. LISA RENEE BERMEO (NPI# 1629205349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629205349 |
| Entity Type | Individual |
| Full Name | MS. LISA RENEE BERMEO |
| Credential | LCSW |
| Practice Address |
99 Montecillo Rd San Rafael CA 94903-3308 |
| Mailing Address |
6 Baker Ct Petaluma CA 94952-5520 |
| Practice Telephone | 4154444251 |
| Mailing Telephone | 7072285368 |
| Mailing Fax Number | 7077731766 |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2009-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
25074 | CA | Behavioral Health & Social Service Providers |
| Street Address |
99 MONTECILLO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1568001071 | Jessica Tan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-31 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740765106 | Judith Shaffer | Social Worker | 108 Maywood Way, San Rafael, CA 94901-1132 | 2018-10-01 |
| 1932627056 | Jessica Aldrich Strassman | Social Worker | 822 D St # 8, San Rafael, CA 94901-2814 | 2017-09-08 |
| 1316355654 | Loretta Dannean Farris | Social Worker | 1821 5th Ave Apt B320, San Rafael, CA 94901-1788 | 2014-07-31 |
| 1114361318 | Arley Lindberg | Social Worker | 1206 3rd St Ste 6, San Rafael, CA 94901-3048 | 2013-04-18 |
| 1720337017 | Barbara J Sylvester | Social Worker | 601 N San Pedro Rd, San Rafael, CA 94903-3038 | 2012-09-03 |
| 1982968715 | Marianne Gontarz York | Social Worker | 8 Diego Dr, San Rafael, CA 94903-2314 | 2012-06-26 |
| 1942510037 | Aneissa Marie Rosas-sanchez | Social Worker | 92 Louise St, San Rafael, CA 94901-4760 | 2010-10-07 |
| 1992018436 | Lynn Christine Ervin | Social Worker | 700 E St Ste 102, San Rafael, CA 94901 | 2010-07-26 |
| 1134352099 | Claudia Benitez | Social Worker | 361 3rd St Ste G, San Rafael, CA 94901-3580 | 2009-08-26 |
| 1811137284 | Deborah Marie Levin | Social Worker | 252 Devon Dr, San Rafael, CA 94903-3756 | 2009-02-25 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.