Individual provider Active NPI

Tiffany Wadkins, ASOCIATE LCSW

  • Clinical Social Worker
  • Encino, CA
National Provider Identifier
1265112759
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115603 Issued in CA
Practice address
15720 Ventura Blvd
Encino, CA 91436-2914
Phone
(818) 927-0478
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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 115603 CA Primary

Addresses

Primary practice location

15720 Ventura Blvd
Encino, CA 91436-2914

Mailing address

980 S Cornucopia Rd
Exeter, CA 93221-9612
Phone (559) 802-2185

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

LicenseStateTypeSpecialty
115603CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1265112759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S CORNUCOPIA RD",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932219612",
            "telephone_number": "559-802-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-927-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADKINS",
        "first_name": "TIFFANY",
        "credential": "ASOCIATE LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.