Active NPI
Kelly K. Fuchino, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1255636619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS23853
- Practice address
- 1505 N Edgemont St
1St Floor, Social Medicine
Los Angeles, CA 90027-5209 - Phone
- (323) 783-4371
- NPI assigned
- Jan 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS23853 | CA | Primary |
Addresses
Primary practice location
1505 N Edgemont St
1St Floor, Social Medicine
Los Angeles, CA 90027-5209
Mailing address
1505 N Edgemont St
Social Medicine, 1St Floor
Los Angeles, CA 90027-5209
Phone (323) 783-4371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS23853 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1255636619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 N EDGEMONT ST",
"address_2": "SOCIAL MEDICINE, 1ST FLOOR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275209",
"telephone_number": "323-783-4371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 N EDGEMONT ST",
"address_2": "1ST FLOOR, SOCIAL MEDICINE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275209",
"telephone_number": "323-783-4371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUCHINO",
"first_name": "KELLY",
"middle_name": "K.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-17",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS23853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.