Kym M Andrews-Cardoza
Individual provider Active NPI Clinical Social Worker · Placerville, CA
NPI 1073022414 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1073022414
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 119493 (CA)
- Practice address
- 3057 Briw Rd
Placerville, CA 95667-5330 - Phone
- (530) 748-5328
- NPI assigned
- Sep 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shingle Springs Rancheria
Practice addresses (Care Compare)
5168 Honpie Rd
Placerville, CA 95667-8682
Phone (530) 387-4975
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241002000763 | CA | Practitioner - Clinical Social Worker | 4284165226 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119493 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shingle Springs Rancheria | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 119493 | CA | Yes |
Addresses
Primary practice location
3057 Briw Rd
Placerville, CA 95667-5330
Mailing address
PO Box 1562
Folsom, CA 95763-1562
Phone (530) 748-5328
Other providers in Placerville, CA
- Raphael Kadoory Amir
- Gina Anderson
- Kendra Anderson
- Robert Emmett Anderson
- Suzanne T Anderson
- Kristen A Andrews
- Cesar Koa Ang
- Lisa Appleton
- Laura Lynne Arevalo
- Jerry P Arnold
All providers in Placerville, 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 Dec 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.