Individual provider Active NPI

Patricia Alice, L.C.S.W.

  • Clinical Social Worker
  • Apple Valley, CA
National Provider Identifier
1245480763
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS9645 Issued in CA
Practice address
16390 Shenandoah Rd
Apple Valley, CA 92307-1758
Phone
(760) 242-7995
Fax
(760) 242-7995
NPI assigned
Sep 19, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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 LCS9645 CA Primary

Addresses

Primary practice location

16390 Shenandoah Rd
Apple Valley, CA 92307-1758

Mailing address

16390 Shenandoah Rd
Apple Valley, CA 92307-1758
Phone (760) 242-7995

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
I20081120000210 CA Practitioner - Clinical Social Worker 7214096965 Practice locations: Apple Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15580 Pohez Rd
Apple Valley, CA 92307-4662
Phone (760) 242-7995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS9645CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1245480763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16390 SHENANDOAH RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071758",
            "telephone_number": "760-242-7995",
            "fax_number": "760-242-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16390 SHENANDOAH RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071758",
            "telephone_number": "760-242-7995",
            "fax_number": "760-242-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICE",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS9645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.