Individual provider Active NPI

Keav Siv Khov, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1124557657
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW72283 Issued in CA
Practice address
4510 East Pacific Coast Highway
Suite 600
Long Beach, CA 90804
Phone
(562) 346-1100
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 LCSW72283 CA Primary

Addresses

Primary practice location

4510 East Pacific Coast Highway
Suite 600
Long Beach, CA 90804

Mailing address

4510 E Pacific Coast Hwy Ste 600
Long Beach, CA 90804-6914
Phone (562) 346-1100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW72283CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124557657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 E PACIFIC COAST HWY STE 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908046914",
            "telephone_number": "562-346-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EAST PACIFIC COAST HIGHWAY",
            "address_2": "SUITE 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90804",
            "telephone_number": "562-346-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOV",
        "first_name": "KEAV",
        "middle_name": "SIV",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW72283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.