Individual provider Active NPI

Edna Lila Carrasco, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1154683308
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28263 Issued in CA
Practice address
7300 Wyndham Dr
Sacramento, CA 95823-4913
Phone
(916) 525-6714
Fax
(916) 525-6188
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 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 28263 CA Primary

Addresses

Primary practice location

7300 Wyndham Dr
Sacramento, CA 95823-4913

Mailing address

7300 Wyndham Dr
Sacramento, CA 95823-4913
Phone (916) 525-6714

Other names 1

  • Edna L Ochoa Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150304001170 CA Practitioner - Clinical Social Worker 1052637352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28263CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Sep 18, 2021 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

7300 Wyndham Dr
Sacramento, CA 95823
Phone (916) 525-6100

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1154683308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 WYNDHAM DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234913",
            "telephone_number": "916-525-6714",
            "fax_number": "916-525-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 WYNDHAM DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234913",
            "telephone_number": "916-525-6714",
            "fax_number": "916-525-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "EDNA",
        "middle_name": "LILA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2022-02-11",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 Wyndham Dr",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EDNA",
            "last_name": "OCHOA",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.