Individual provider Active NPI

Christina O'Halloran, PHD, LCSW

  • Clinical Social Worker
  • Santa Cruz, CA
National Provider Identifier
1073903050
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 17848 Issued in CA
Practice address
143 Stockton Ave
Santa Cruz, CA 95060-6219
Phone
(831) 818-9664
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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 LCS 17848 CA Primary

Addresses

Primary practice location

143 Stockton Ave
Santa Cruz, CA 95060-6219

Mailing address

143 Stockton Ave
Santa Cruz, CA 95060-6219
Phone (831) 818-9664

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCS 17848CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1073903050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 STOCKTON AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950606219",
            "telephone_number": "831-818-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 STOCKTON AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950606219",
            "telephone_number": "831-818-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HALLORAN",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 17848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.