Active NPI
Samantha Nicole Keung
- Clinical Social Worker
- Pasadena, CA
National Provider Identifier
1215422902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 89291
- Practice address
- 940 Avenue 64
Pasadena, CA 91105-2711 - Phone
- (323) 254-2274
- NPI assigned
- Jun 26, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 89291 | CA | Primary |
Addresses
Primary practice location
940 Avenue 64
Pasadena, CA 91105-2711
Mailing address
815 Colorado Blvd Ste 300
Los Angeles, CA 90041-1744
Phone (323) 543-2800
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89291 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1215422902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 COLORADO BLVD STE 300",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411744",
"telephone_number": "323-543-2800",
"fax_number": "323-978-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 AVENUE 64",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052711",
"telephone_number": "323-254-2274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEUNG",
"first_name": "SAMANTHA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-26",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "89291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.