Active NPI
Rebecca Ann Patch Crofut
- Clinical Social Worker
- Westminster, CA
National Provider Identifier
1033540307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 90794
- Practice address
- 14140 Beach Blvd
155
Westminster, CA 92683-4453 - Phone
- (714) 896-7556
- Fax
- (714) 896-7564
- NPI assigned
- Dec 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 90794 | CA | Primary |
Addresses
Primary practice location
14140 Beach Blvd
155
Westminster, CA 92683-4453
Mailing address
14140 Beach Blvd
155
Westminster, CA 92683-4453
Phone (714) 896-7556
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90794 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1033540307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14140 BEACH BLVD",
"address_2": "155",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926834453",
"telephone_number": "714-896-7556",
"fax_number": "714-896-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14140 BEACH BLVD",
"address_2": "155",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926834453",
"telephone_number": "714-896-7556",
"fax_number": "714-896-7564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROFUT",
"first_name": "REBECCA",
"middle_name": "ANN PATCH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-11",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "90794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.