Active NPI
Deborah Ann Devine, LCSW
- Clinical Social Worker
- Lancaster, CA
National Provider Identifier
1104943695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS13014
- Practice address
- 921 W Avenue J
Lancaster, CA 93534-3443 - Phone
- (661) 949-0131
- Fax
- (661) 729-8912
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS13014 | CA | Primary |
Addresses
Primary practice location
921 W Avenue J
Lancaster, CA 93534-3443
Mailing address
2800 Bay Ridge CT
Palmdale, CA 93551-4670
Phone (661) 949-0131
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00007473 | Medicaid | CA | |
| 00007301 | Medicaid | CA | |
| CBSC102 | Other | CA | LA DMH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS13014 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104943695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 BAY RIDGE CT",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935514670",
"telephone_number": "661-949-0131",
"fax_number": "661-729-8912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 W AVENUE J",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935343443",
"telephone_number": "661-949-0131",
"fax_number": "661-729-8912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINE",
"first_name": "DEBORAH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS13014",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00007473",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00007301",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA DMH",
"identifier": "CBSC102",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.