Kieu Balthasar, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

76413 Issued in CA

Practice address

19742 Macarthur Blvd Ste 100
Irvine, CA 92612-2408

Phone

(714) 646-8034

Fax

(714) 492-8264

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chiron Psychological IncGroup PAC ID 9234496308, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chiron Psychological, Inc

  • Psychologist
  • Irvine, CA
  • NPI 1467984377

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1093439937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18200 YORBA LINDA BLVD STE 111",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864043",
            "telephone_number": "714-646-8034",
            "fax_number": "714-492-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122408",
            "telephone_number": "714-646-8034",
            "fax_number": "714-492-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTHASAR",
        "first_name": "KIEU",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meg Camille Tiangco Baldonado, FNP-C
• Lisa Baldwin, LMFT
• Fredric D. Balguma, DO
• Salah Eddine Hussein Balkis
• Jason Balsom
• George Joseph Baltz, LCSW
• Tyrone Balucanag, DC
• Fabiana P Bamberger, DC
• Gregory A Bamberger, DC
• Nathan Banaag

• Clinical Social Worker in Irvine, CA
• Providers in Irvine, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.