Individual provider Active NPI

Etana G Kempner, L.C.S.W.

  • Clinical Social Worker
  • Laguna Beach, CA
National Provider Identifier
1033407622
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27177 Issued in CA
Practice address
32392 Coast Hwy
Suite 250
Laguna Beach, CA 92651-6776
Phone
(949) 499-2265
Fax
(949) 499-2276
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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 27177 CA Primary

Addresses

Primary practice location

32392 Coast Hwy
Suite 250
Laguna Beach, CA 92651-6776

Mailing address

32392 S. Coast Hwy
Suite 250
Laguna Beach, CA 92651
Phone (949) 636-8460

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Laguna Family Health Center, a Nursing Corporation Clinical Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1033407622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32392 S. COAST HWY",
            "address_2": "SUITE 250",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92651",
            "telephone_number": "949-636-8460",
            "fax_number": "949-499-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32392 COAST HWY",
            "address_2": "SUITE 250",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516776",
            "telephone_number": "949-499-2265",
            "fax_number": "949-499-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPNER",
        "first_name": "ETANA",
        "middle_name": "G",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.