Active NPI
Tina Marie Charley
- Social Worker
- Cerritos, CA
National Provider Identifier
1073164612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 17707 Studebaker Rd Ste 208
Cerritos, CA 90703-2640 - Phone
- (562) 402-0677
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
17707 Studebaker Rd Ste 208
Cerritos, CA 90703-2640
Mailing address
12603 Ibbetson Ave
Downey, CA 90242-5049
Phone (323) 517-4326
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1073164612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12603 IBBETSON AVE",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902425049",
"telephone_number": "323-517-4326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17707 STUDEBAKER RD STE 208",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907032640",
"telephone_number": "562-402-0677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLEY",
"first_name": "TINA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.