Individual provider Active NPI

Sandra Lee Krikorian, LCSW

  • Clinical Social Worker
  • Santa Rosa, CA
National Provider Identifier
1205295979
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW22700 Issued in CA
Practice address
100 E St Ste 314
Santa Rosa, CA 95404-4607
Phone
(707) 579-0838
Fax
(707) 620-0367
NPI assigned
Feb 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 LCSW22700 CA Primary

Addresses

Primary practice location

100 E St Ste 314
Santa Rosa, CA 95404-4607

Mailing address

100 E St Ste 314
Santa Rosa, CA 95404-4607
Phone (707) 579-0838

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
I20161221001035 CA Practitioner - Clinical Social Worker 4789965203 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 E St
Suite 312
Santa Rosa, CA 95404-4607
Phone (707) 579-0838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW22700CAMDClinical Social Worker
22700CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1205295979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E ST STE 314",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044607",
            "telephone_number": "707-579-0838",
            "fax_number": "707-620-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ST STE 314",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044607",
            "telephone_number": "707-579-0838",
            "fax_number": "707-620-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIKORIAN",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW22700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.