Active NPI
Kristen Michelle Levin, LCSW
- Social Worker
- Dana Point, CA
National Provider Identifier
1306143821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 25612 Rusty Anchor St
Dana Point, CA 92629-1528 - Phone
- (949) 416-0410
- NPI assigned
- Feb 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 69108 | CA | |
| Clinical Social Worker | 1041C0700X | 60670116 | WA | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
25612 Rusty Anchor St
Dana Point, CA 92629-1528
Mailing address
PO Box 4073
Dana Point, CA 92629-9073
Phone (949) 416-0410
Other names 1
- Kristen Michelle Pass
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60670116 | WA | MD | Clinical Social Worker |
| 69108 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664668800000",
"number": "1306143821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4073",
"city": "DANA POINT",
"state": "CA",
"postal_code": "926299073",
"telephone_number": "949-416-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25612 RUSTY ANCHOR ST",
"city": "DANA POINT",
"state": "CA",
"postal_code": "926291528",
"telephone_number": "949-416-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVIN",
"first_name": "KRISTEN",
"middle_name": "MICHELLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-18",
"last_updated": "2022-10-02",
"certification_date": "2022-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "69108",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "60670116",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "PASS",
"middle_name": "MICHELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Dana Point, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.