Individual provider Active NPI

Victoria Kay Maricich, LCSW

  • Clinical Social Worker
  • Newport Beach, CA
National Provider Identifier
1154475374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 19414 Issued in CA
Practice address
1501 E 16TH St
Newport Beach, CA 92663-5924
Phone
(949) 650-9750
Fax
(949) 650-9768
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS 19414 CA Primary

Addresses

Primary practice location

1501 E 16TH St
Newport Beach, CA 92663-5924

Mailing address

5562 Tammarisk Dr
Yorba Linda, CA 92886-4916
Phone (714) 747-5088

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
LCS 19414CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154475374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 TAMMARISK DR",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864916",
            "telephone_number": "714-747-5088",
            "fax_number": "949-223-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 16TH ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635924",
            "telephone_number": "949-650-9750",
            "fax_number": "949-650-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARICICH",
        "first_name": "VICTORIA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 19414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.