Susann Marie Adams, LCSW
Individual provider Active NPI Clinical Social Worker · Loma Linda, CA
NPI 1295849362 · NPPES record last updated Feb 1, 2016
Key facts
- NPI
- 1295849362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 10825 (MD)
- Practice address
- 11201 Benton St
Loma Linda, CA 92357-1000 - Phone
- (909) 825-7084
- Fax
- (909) 777-3226
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10825 | MD | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10825 | MD | Yes |
Addresses
Primary practice location
11201 Benton St
Loma Linda, CA 92357-1000
Mailing address
PO Box 2304
Palm Desert, CA 92261-2304
Phone (909) 825-7084
NPI Registry JSON
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1295849362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2304",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922612304",
"telephone_number": "909-825-7084",
"fax_number": "909-777-3326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 BENTON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923571000",
"telephone_number": "909-825-7084",
"fax_number": "909-777-3226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "SUSANN",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "10825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
- Ana Marie Acosta
- Anna Reyna Acosta
- Michael David Acquistapace
- Linda Adams
- Matthew W Adams
- Amyela Javier Adarlo
- Raychelle Harper Addo
- Adelaida S. Galasinao
- Oluwaseun Adelanke Adetayo
- Andranig Andy Adjemian
All providers in Loma Linda, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.