Individual provider Active NPI

Tana Teicheira, LCSW

  • Clinical Social Worker
  • Marina del Rey, CA
National Provider Identifier
1023133816
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
83675 Issued in CA
Practice address
4712 Admiralty Way # 704
Marina del Rey, CA 90292-6905
Phone
(707) 716-6390
NPI assigned
Mar 20, 2007
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 83675 CA Primary

Addresses

Primary practice location

4712 Admiralty Way # 704
Marina del Rey, CA 90292-6905

Mailing address

4712 Admiralty Way # 704
Marina del Rey, CA 90292-6905
Phone (707) 716-6390

Other names 1

  • Tana Teicheira Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201001002007 CA Practitioner - Clinical Social Worker 1355236597
I20220420000561 HI Practitioner - Clinical Social Worker 1355236597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pau Hana Counseling, LLCGroup PAC ID 6406263342, 5 clinicians

Practice addresses (Care Compare)

224 Kamehameha Ave
Suite 201
Hilo, HI 96720-2860
Phone (808) 825-4212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Studio City Clinical Associates a Licensed Clinical Social Worker Corp Clinical CurrentSince Jul 24, 2020 Accepting new patients
Pau Hana Counseling, LLC CurrentSince Feb 1, 2022 Accepting new patients
Caring Kind Home Health Care, Inc. PastSince Feb 19, 2023 Accepting new patients

Locations

1800 Vine St
Ste 100
Los Angeles, CA 90028
Phone (310) 472-2523

11712 Moorpark St
Ste 111
Studio City, CA 91604
Phone (310) 415-5732

11712 Moorpark St
Ste 205B
Studio City, CA 91604
Phone (747) 800-0012

224 Kamehameha Ave
Ste 201
Hilo, HI 96720
Phone (808) 825-4212

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1023133816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY # 704",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "707-716-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY # 704",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "707-716-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEICHEIRA",
        "first_name": "TANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANA",
            "last_name": "TEICHEIRA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.