Individual provider Active NPI

Rajdeep K Samra, LCSW

  • Social Worker
  • Bakersfield, CA
National Provider Identifier
1215206180
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
4900 California Ave
Bakersfield, CA 93309-7024
Phone
(661) 852-2874
NPI assigned
Dec 22, 2011
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

4900 California Ave
Bakersfield, CA 93309-7024

Mailing address

15008 Northampton Ave
Bakersfield, CA 93314-4301
Phone (818) 602-8354

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
I20240913002798 CA Practitioner - Clinical Social Worker 3678013828 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 6, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 6, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1215206180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15008 NORTHAMPTON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933144301",
            "telephone_number": "818-602-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097024",
            "telephone_number": "661-852-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMRA",
        "first_name": "RAJDEEP",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.