NPIMap

Individual provider Active NPI

Malik Rahsaan Tate, MSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1316241771
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 25938 Issued in CA
Practice address
11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003
Phone
(310) 482-6666
NPI assigned
Dec 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 LCS 25938 CA Primary

Addresses

Primary practice location

11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003

Mailing address

11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003
Phone (310) 482-6666

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
LCS 25938CAMDClinical Social Worker
25938CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Past Accepting new patients

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1316241771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11303 W WASHINGTON BLVD",
            "address_2": "#200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666003",
            "telephone_number": "310-482-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11303 W WASHINGTON BLVD",
            "address_2": "#200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666003",
            "telephone_number": "310-482-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "MALIK",
        "middle_name": "RAHSAAN",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 25938",
            "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 Dec 28, 2010; 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.