Individual provider Active NPI

Amy Lynn Maddigan, L.C.S.W.

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1235336918
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 22854 Issued in CA
Practice address
1900 Royalty Dr Ste 180
Pomona, CA 91767-3046
Phone
(909) 623-6131
Fax
(909) 623-6131
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 LCS 22854 CA Primary

Addresses

Primary practice location

1900 Royalty Dr Ste 180
Pomona, CA 91767-3046

Mailing address

1900 Royalty Dr Ste 180
Pomona, CA 91767-3046
Phone (909) 623-6131

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
I20110106000680 CA Practitioner - Clinical Social Worker 2567651599 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 22854CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Mental Health Authority CurrentSince Apr 18, 2026 Accepting new patients
Tri-City Mental Health Center PastSince Apr 18, 2026 Accepting new patients

Locations

2008 N Garey Ave
Pomona, CA 91767
Phone (909) 242-7640

Organizations & group practices 2

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1235336918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR STE 180",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673046",
            "telephone_number": "909-623-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR STE 180",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673046",
            "telephone_number": "909-623-6131",
            "fax_number": "909-623-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDIGAN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.