Fallon Elaine Greene, LCSW
Individual provider Active NPI Clinical Social Worker · Crestline, CA
NPI 1023909223 · NPPES record last updated Sep 20, 2025
Key facts
- NPI
- 1023909223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 131632 (CA)
- Practice address
- PO Box 72
Crestline, CA 92325-0072 - Phone
- (909) 754-8864
- NPI assigned
- Jul 14, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131632 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 131632 | CA | Yes |
Addresses
Primary practice location
PO Box 72
Crestline, CA 92325-0072
Mailing address
PO Box 72
Crestline, CA 92325-0072
Phone (909) 754-8864
Other providers in Crestline, CA
- Bethany Gilliland
- Tyler J Glenn
- Natasha Charlene Gordon
- Joanna Granillo
- Amber Ray Gray
- Victoria Greene
- Kevin Griego
- Chelsea L Guest
- Angela Marguerite Harrington
- Monica Harrison
All providers in Crestline, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.