Susan Jo Kagan Van Campen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10913 Issued in CA

Practice address

10800 Magnolia Ave
Riverside, CA 92505-3043

Phone

(951) 358-2625

Fax

(951) 358-2697

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205053840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22720 VAN BUREN ST",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135700",
            "telephone_number": "951-358-2625",
            "fax_number": "951-358-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053043",
            "telephone_number": "951-358-2625",
            "fax_number": "951-358-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN CAMPEN",
        "first_name": "SUSAN",
        "middle_name": "JO KAGAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "10913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chelsea Van Gorder, OTD, OTR/L
• Betty Jo Van Horn, RN
• Carissa Van Horssen
• Nicole Renee Van Over, M.A.
• Taska Van Swol, MD

• Clinical Social Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Social Worker in California

• 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.