BETHANY THEODORE LCSW
NPI 1427465277
Social Worker - Clinical in San Jose, CA

Q: What is Bethany Theodore's NPI number?

The NPI number for Bethany Theodore is 1427465277. It was assigned to this individual provider in the NPPES registry on July 14, 2014.

Q: What is Bethany Theodore's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Bethany Theodore was last updated on September 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2014PECOS Enrolled

99 ALMADEN BLVD STE 600, SAN JOSE, CA 95113(707) 527-2064 Get Directions Write a Review

NPPES record last updated: September 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 9, 2023, Feb 1, 2023, Jan 9, 2023 (3 updates tracked since 2023).

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About Bethany Theodore Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANY THEODORE LCSW (NPI 1427465277) is an individual clinical provider in San Jose, California, licensed in California (90745) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Rosa, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1427465277

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameBETHANY THEODORECredential: LCSW

Location Address99 ALMADEN BLVD STE 600San Jose, CA 95113-6489

Mailing AddressPo Box 7614Newark, DE 19714-7614 · (484) 602-9681

Phone(707) 527-2064

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 14, 2014

Last NPPES UpdateSeptember 9, 20233 updates tracked since enumeration

NPPES CertifiedAugust 18, 2023

✔ NPI 1427465277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 90745

Definition

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License ASW59950 (CA)

99 ALMADEN BLVD STE 600, San Jose, CA 95113

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Secondary Practice Location 1

Location 17425 Rancho Los Guilicos RdSanta Rosa, CA 95409-6519 · Phone (707) 565-8682

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bethany Theodore Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID42778342

PECOS Enrollment IDI20260818000161

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Bethany Theodore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Forward Wellness Family Therapy, Inc.

329 mi

Community/Behavioral Health

1041 E YORBA LINDA BLVD STE 202
Placentia, CA 92870

Reassigned Medicare billing, California enrollment
150 clinicians in this Medicare group

NPI 1093398059 (800) 701-0937

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95113 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $70.37 – $206.04

Typical copayment $0.00 (range $17.59 – $51.51)

Most-billed visit code NA

Established Patient

$86.56 typical visit price

range $23.96 – $169.60

Typical copayment $21.64 (range $5.99 – $42.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VECTOR REMOTE CARE, LLC

Physiological Laboratory