Individual provider Active NPI

Alicia Laurel Mittleman, LCSW

  • Clinical Social Worker
  • West Sacramento, CA
National Provider Identifier
1205291044
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28794 Issued in CA
Practice address
3880 Fowler Rd
West Sacramento, CA 95691-5491
Phone
(916) 425-7733
Fax
(916) 372-2466
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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 28794 CA Primary

Addresses

Primary practice location

3880 Fowler Rd
West Sacramento, CA 95691-5491

Mailing address

3880 Fowler Rd
West Sacramento, CA 95691-5491
Phone (916) 425-7733

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
I20170206002030 CA Practitioner - Clinical Social Worker 5395028922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2945 Ramco St
Suite 110
West Sacramento, CA 95691-5998
Phone (916) 425-7733

3880 Fowler Rd
West Sacramento, CA 95691-5491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28794CAMDSpeech-Language Pathologist

Organizations & group practices 1

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1205291044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 FOWLER RD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915491",
            "telephone_number": "916-425-7733",
            "fax_number": "916-372-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 FOWLER RD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915491",
            "telephone_number": "916-425-7733",
            "fax_number": "916-372-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTLEMAN",
        "first_name": "ALICIA",
        "middle_name": "LAUREL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

Verify at the official NPI Registry.