Individual provider Active NPI

Mayashree Bhaumik, LCSW,PH.D

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1306061023
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW4139 Issued in CA
Practice address
765 W College St
Los Angeles, CA 90012-1181
Phone
(213) 580-7276
Fax
(213) 580-7308
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCSW4139 CA Primary

Addresses

Primary practice location

765 W College St
Los Angeles, CA 90012-1181

Mailing address

1840 Arriba Dr
Monterey Park, CA 91754-2324
Phone (323) 269-1888

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCSW4139CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306061023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 ARRIBA DR",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542324",
            "telephone_number": "323-269-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 W COLLEGE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121181",
            "telephone_number": "213-580-7276",
            "fax_number": "213-580-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAUMIK",
        "first_name": "MAYASHREE",
        "credential": "LCSW,PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW4139",
            "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 Jul 8, 2007; 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.