Active NPI
Sandra Jill Allen, LCSW
- Social Worker
- Los Angeles, CA
National Provider Identifier
1255463097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 16889
- Practice address
- 11301 Wilshire Blvd BLDG 206
Room 33
Los Angeles, CA 90073-1003 - Phone
- (310) 478-3711
- Fax
- (310) 268-4378
- NPI assigned
- Mar 9, 2007
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 16889 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd BLDG 206
Room 33
Los Angeles, CA 90073-1003
Mailing address
11301 Wilshire Blvd BLDG 206
Room 33
Los Angeles, CA 90073-1003
Phone (310) 478-3711
Other practice location 1
444 W Fort St. Fl 2
Boise, ID 83702-4535
Phone (208) 422-1018
Other names 1
- Sandra Jill Davidson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16889 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1255463097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD BLDG 206",
"address_2": "ROOM 33",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711",
"fax_number": "310-268-4378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD BLDG 206",
"address_2": "ROOM 33",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711",
"fax_number": "310-268-4378"
}
],
"practiceLocations": [
{
"address_1": "444 W Fort St. Fl 2",
"address_purpose": "LOCATION",
"city": "BOISE",
"state": "ID",
"postal_code": "837024535",
"country_code": "US",
"telephone_number": "208-422-1018",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALLEN",
"first_name": "SANDRA",
"middle_name": "JILL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "16889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "DAVIDSON",
"middle_name": "JILL",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.