Active NPI
Patricia Sutherland
- Clinical Social Worker
- Fountain Valley, CA
National Provider Identifier
1144796525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 99159
- Practice address
- 17350 Mount Herrmann St
Fountain Valley, CA 92708-4114 - Phone
- (714) 444-3463
- NPI assigned
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | 99159 | CA | Primary |
Addresses
Primary practice location
17350 Mount Herrmann St
Fountain Valley, CA 92708-4114
Mailing address
17350 Mount Herrmann St
Fountain Valley, CA 92708-4114
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 |
|---|---|---|---|
| 99159 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1144796525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17350 MOUNT HERRMANN ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17350 MOUNT HERRMANN ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927084114",
"telephone_number": "714-444-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-23",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "99159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
- Sunrise Home Health Care LLC
- Sunshine Guest Home LLC
- Sunshine Hospice of Southern California Inc
- Surgitek ASC LLC
- Susan Shao L.Ac.
- Lucy E Suwarsa, MD
- Swaroop Medical Corporation (Cardiology Medical Group of OC)
- Satinder Swaroop, MD
- Amy Cheng Ping Swei, L.AC.,D.N.B.A.O.
- Davida Jacqueline Swhartz, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.