Active NPI
Jordan Dunyasha Vix, MSW/LCSW
- Clinical Social Worker
- Lancaster, CA
National Provider Identifier
1174652598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 25864
- Practice address
- 349A E Avenue K6
Lancaster, CA 93535-4548 - Phone
- (661) 974-8400
- Fax
- (661) 729-2186
- NPI assigned
- Mar 2, 2007
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 20718 | CA | |
| Clinical Social Worker | 1041C0700X | 25864 | CA | Primary |
Addresses
Primary practice location
349A E Avenue K6
Lancaster, CA 93535-4548
Mailing address
2010 W Avenue K # 389
Lancaster, CA 93536-5229
Phone (661) 974-8417
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159510 | Other | CA | IS SVX LOC # |
| W2983 | Other | CA | MEDICARE GROUP |
| HI557Z | Other | CA | PTAN |
Other names 1
- Jordan Dunyasha Dunyasha/Shanahan
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20718 | CA | MD | Pediatric Occupational Therapist |
| 25864 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382572800000",
"number": "1174652598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 W AVENUE K # 389",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935365229",
"telephone_number": "661-974-8417",
"fax_number": "661-729-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349A E AVENUE K6",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935354548",
"telephone_number": "661-974-8400",
"fax_number": "661-729-2186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIX",
"first_name": "JORDAN",
"middle_name": "DUNYASHA",
"name_prefix": "Ms.",
"credential": "MSW/LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2013-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "20718",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "25864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IS SVX LOC #",
"identifier": "159510",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "W2983",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "HI557Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JORDAN",
"last_name": "DUNYASHA/SHANAHAN",
"middle_name": "DUNYASHA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.