Individual provider Active NPI

Kiara Andrea Laster, ACSW

  • Clinical Social Worker
  • Manteca, CA
National Provider Identifier
1164093308
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127074 Issued in CA
Practice address
302 Cherry LN Ste 201
Manteca, CA 95337-4311
Phone
(209) 647-6200
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 101525 CA
Social Worker 104100000X 101525 CA
Clinical Social Worker 1041C0700X 127074 CA Primary

Addresses

Primary practice location

302 Cherry LN Ste 201
Manteca, CA 95337-4311

Mailing address

302 Cherry LN Ste 201
Manteca, CA 95337-4311
Phone (209) 647-6200

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
I20260313001738 CA Practitioner - Clinical Social Worker 5193208585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552

21151 S Western Ave
Suite B22
Torrance, CA 90501-1724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101525CAMDSocial Worker
127074CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Community Support Services, Inc. CurrentSince Dec 26, 2021 Accepting new patients
County of San Joaquin CurrentSince Jan 28, 2026 Accepting new patients
San Joaquin County Behavioral Health Services CurrentSince Jan 28, 2026 Accepting new patients
Victor Community Support Services, Inc. PastSince Oct 1, 2019 Accepting new patients

Locations

1908 Business Center Dr
San Bernardino, CA 92408
Phone (909) 890-5930

Organizations & group practices 5

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1164093308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 201",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "209-647-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 201",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "209-647-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTER",
        "first_name": "KIARA",
        "middle_name": "ANDREA",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "101525",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "101525",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "127074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.