Individual provider Active NPI

Kristen Ivers Williams, LCSW

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1265775589
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW22291 Issued in CA
Practice address
19742 Macarthur Blvd Ste 100
Irvine, CA 92612-2408
Phone
(714) 646-8034
Fax
(714) 492-8264
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS22291 CA
Clinical Social Worker 1041C0700X LCSW22291 CA Primary

Addresses

Primary practice location

19742 Macarthur Blvd Ste 100
Irvine, CA 92612-2408

Mailing address

18200 Yorba Linda Blvd Ste 111
Yorba Linda, CA 92886-4043

Other practice location 1

18200 Yorba Linda Blvd Ste 106
Yorba Linda, CA 92886-4006
Phone (714) 646-8034

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
I20231031003531 CA Practitioner - Clinical Social Worker 0547616278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiron Psychological IncGroup PAC ID 9234496308, 15 clinicians

Practice addresses (Care Compare)

18200 Yorba Linda Blvd
Suite 106
Yorba Linda, CA 92886-4006
Phone (714) 646-8034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS22291CAMDClinical Social Worker
LCSW22291CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chiron Psychological, Inc Clinical CurrentSince Oct 1, 2023 Accepting new patients

Locations

19742 MacArthur Blvd
Ste 100
Irvine, CA 92612
Phone (714) 646-8034

19742 MacArthur Blvd
Ste 125
Irvine, CA 92612
Phone (714) 402-6437

19742 MacArthur Blvd
Ste 135
Irvine, CA 92612
Phone (714) 646-8034

18200 Yorba Linda Blvd
Ste 111
Yorba Linda, CA 92886

18200 Yorba Linda Blvd
Ste 106
Yorba Linda, CA 92886
Phone (714) 646-8034

Organizations & group practices 1

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1265775589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18200 YORBA LINDA BLVD STE 111",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122408",
            "telephone_number": "714-646-8034",
            "fax_number": "714-492-8264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18200 Yorba Linda Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Yorba Linda",
            "state": "CA",
            "postal_code": "928864006",
            "country_code": "US",
            "telephone_number": "714-646-8034",
            "fax_number": "714-492-8264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTEN",
        "middle_name": "IVERS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2023-10-19",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS22291",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW22291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.