Individual provider Active NPI

Dyan Gale Kolb, LCSW

  • Clinical Social Worker
  • Torrance, CA
National Provider Identifier
1235352683
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 27767 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(310) 222-1634
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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 27767 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

4055 La Salle Ave # 2
Culver City, CA 90232-3207
Phone (310) 222-1634

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
I20131029001629 CA Practitioner - Clinical Social Worker 9931334950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 W Carson St
DMH Harbor UCLA
Torrance, CA 90509-2004
Phone (213) 430-6700

2311 W El Segundo Blvd
South Bay MHS
Hawthorne, CA 90250-3315
Phone (310) 241-6730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 27767CAMDClinical Social Worker
27767CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Sep 20, 2014 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Sep 20, 2014 Accepting new patients

Locations

2311 W El Segundo Blvd
Hawthorne, CA 90250
Phone (310) 241-6730

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1235352683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 LA SALLE AVE # 2",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323207",
            "telephone_number": "310-222-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "DYAN",
        "middle_name": "GALE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 27767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.