John Robert Green, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LT11036 Issued in CA

Practice address

7738 W 80TH St
Playa del Rey, CA 90293-7972

Phone

(310) 822-2782

Fax

(310) 533-8019

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326120478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7738 W 80TH ST",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937972",
            "telephone_number": "310-822-2782",
            "fax_number": "310-533-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7738 W 80TH ST",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937972",
            "telephone_number": "310-822-2782",
            "fax_number": "310-533-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LT11036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George P Gleckler, MFT
• Anna Gonzales, OTR
• Lauren Goodell, MPT
• Rush David Goodman, D.M.D.
• Lucinda Charnley Gray, PH.D.
• Dixon Griffin
• Julie Grimmett, M.S. CCC-SLP
• Jerome Alan Guttman, D.D.S.
• Douglas Hales, LMFT
• Joshua Jay Hawkins, DPT

• Clinical Social Worker in Playa del Rey, CA
• Providers in Playa del Rey, CA by specialty
• Clinical Social Worker in California

• 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.