Individual provider Active NPI

Karen Sue Ross, MSW IN CALIF LCSW

  • Psychologist
  • Garden Grove, CA
National Provider Identifier
1003914052
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LCS7205 Issued in CA
Practice address
12377 Lewis St
Suite # 104
Garden Grove, CA 92840-4691
Phone
(714) 703-1366
Fax
(714) 750-0464
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LCS7205 CA Primary

Addresses

Primary practice location

12377 Lewis St
Suite # 104
Garden Grove, CA 92840-4691

Mailing address

12377 Lewis St
Suite # 104
Garden Grove, CA 92840-4691
Phone (714) 703-1366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LCS7205CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003914052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12377 LEWIS ST",
            "address_2": "SUITE # 104",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404691",
            "telephone_number": "714-703-1366",
            "fax_number": "714-750-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12377 LEWIS ST",
            "address_2": "SUITE # 104",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404691",
            "telephone_number": "714-703-1366",
            "fax_number": "714-750-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "MSW IN CALIF LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LCS7205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.