Individual provider Active NPI

Vivian T Lee

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1285804476
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW26823 Issued in CA
Practice address
1730 W Olympic Blvd
Los Angeles, CA 90015-1019
Phone
(213) 553-1884
Fax
(213) 236-9662
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 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 LCSW26823 CA Primary

Addresses

Primary practice location

1730 W Olympic Blvd
Los Angeles, CA 90015-1019

Mailing address

1730 W Olympic Blvd
Los Angeles, CA 90015-1019
Phone (213) 553-1884

Other practice location 1

605 W Olympic Blvd Ste 600
Los Angeles, CA 90015-1475
Phone (213) 236-9394

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW26823CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1285804476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 W Olympic Blvd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900151475",
            "country_code": "US",
            "telephone_number": "213-236-9394",
            "fax_number": "213-236-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "VIVIAN",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW26823",
            "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 Jun 21, 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.