Individual provider Active NPI

Tina Louise Luke

  • Social Worker
  • San Pedro, CA
National Provider Identifier
1063676211
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
704 W 8TH St
San Pedro, CA 90731-3017
Phone
(310) 832-7545
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

704 W 8TH St
San Pedro, CA 90731-3017

Mailing address

7815 E Ring St
Long Beach, CA 90808-3153
Phone (562) 760-9315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250317001686 CA Practitioner - Clinical Social Worker 3678095908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca CurrentSince Mar 9, 2025 Accepting new patients
The San Pedro Clinic Past Accepting new patients

Locations

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 2

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1063676211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7815 E RING ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908083153",
            "telephone_number": "562-760-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W 8TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313017",
            "telephone_number": "310-832-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "TINA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.