Individual provider Active NPI

Victoria Faviola Mursia

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1215466180
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101301 Issued in CA
Practice address
233 S Quintana Dr
Anaheim, CA 92807-4029
Phone
(714) 988-9822
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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 101301 CA Primary

Addresses

Primary practice location

233 S Quintana Dr
Anaheim, CA 92807-4029

Mailing address

233 S Quintana Dr
Anaheim, CA 92807-4029
Phone (714) 988-9822

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
I20250326000879 CA Order and Referring Only - Clinical Social Worker 5799208252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101301CAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1215466180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S QUINTANA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074029",
            "telephone_number": "714-988-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S QUINTANA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074029",
            "telephone_number": "714-988-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURSIA",
        "first_name": "VICTORIA",
        "middle_name": "FAVIOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.