Active NPI
Soraya Dustin, LCSW
- Clinical Social Worker
- Bakersfield, CA
National Provider Identifier
1023601002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW73945
- Practice address
- 4900 California Ave
Tower B 2ND FL
Bakersfield, CA 93309 - Phone
- (901) 422-7636
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW73945 | CA | Primary |
Addresses
Primary practice location
4900 California Ave
Tower B 2ND FL
Bakersfield, CA 93309
Mailing address
40 S Main St Ste 1300
Memphis, TN 38103-5513
Phone (901) 422-7636
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW73945 | CA | MD | Clinical Social Worker |
| 73945 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613692800000",
"number": "1023601002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 S MAIN ST STE 1300",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381035513",
"telephone_number": "901-422-7636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 CALIFORNIA AVE",
"address_2": "TOWER B 2ND FL",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "93309",
"telephone_number": "901-422-7636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUSTIN",
"first_name": "SORAYA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2021-02-19",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW73945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.