Active NPI
Anita Marie Hattendorf, LCSW
- Clinical Social Worker
- Elk Grove, CA
National Provider Identifier
1144422437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS19498
- Practice address
- 8861 Williamson Dr Ste 40
Elk Grove, CA 95624-1878 - Phone
- (916) 685-5258
- Fax
- (916) 670-7880
- NPI assigned
- May 31, 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 | LCS19498 | CA | Primary |
Addresses
Primary practice location
8861 Williamson Dr Ste 40
Elk Grove, CA 95624-1878
Mailing address
8861 Williamson Dr Ste 40
Elk Grove, CA 95624-1878
Phone (916) 685-5258
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080227000135 | CA | Practitioner - Clinical Social Worker | 8628159639 | Practice locations: Elk Grove, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
8861 Williamson Dr
Suite 40
Elk Grove, CA 95624-1878
Phone 916685525819
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS19498 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144422437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8861 WILLIAMSON DR STE 40",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956241878",
"telephone_number": "916-685-5258",
"fax_number": "916-670-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8861 WILLIAMSON DR STE 40",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956241878",
"telephone_number": "916-685-5258",
"fax_number": "916-670-7880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTENDORF",
"first_name": "ANITA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS19498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.