Active NPI
Loretta Dannean Farris, L.C.S.W.
- Clinical Social Worker
- San Rafael, CA
National Provider Identifier
1316355654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS25934
- Practice address
- 1821 5TH Ave Apt B320
San Rafael, CA 94901-1788 - Phone
- (415) 497-5144
- NPI assigned
- Jul 31, 2014
- 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 | LCS25934 | CA | Primary |
| Clinical Social Worker | 1041C0700X | 31638 | TX | |
| Clinical Social Worker | 1041C0700X | KY-1338 | KY |
Addresses
Primary practice location
1821 5TH Ave Apt B320
San Rafael, CA 94901-1788
Mailing address
1821 5TH Ave Apt B320
San Rafael, CA 94901-1788
Phone (415) 497-5144
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 |
|---|---|---|---|
| LCS25934 | CA | MD | Clinical Social Worker |
| KY-1338 | KY | MD | Clinical Social Worker |
| 31638 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1316355654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 5TH AVE APT B320",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011788",
"telephone_number": "415-497-5144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 5TH AVE APT B320",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011788",
"telephone_number": "415-497-5144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRIS",
"first_name": "LORETTA",
"middle_name": "DANNEAN",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-31",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS25934",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "31638",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "KY-1338",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.