Individual provider Active NPI

Cathy Dinice Mangaoang-Welsh, LCSW

  • Clinical Social Worker
  • Stockton, CA
National Provider Identifier
1326262486
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS29035 Issued in CA
Practice address
1151 W Robinhood Dr Ste A8
Stockton, CA 95207-5625
Phone
(209) 607-0463
NPI assigned
Apr 12, 2007
Last updated
Jan 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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 LCS29035 CA Primary

Addresses

Primary practice location

1151 W Robinhood Dr Ste A8
Stockton, CA 95207-5625

Mailing address

1151 W Robinhood Dr Ste A8
Stockton, CA 95207-5625
Phone (209) 607-0463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610002142 CA Practitioner - Clinical Social Worker 3476777533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS29035CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Operating Company, LLC CurrentSince Sep 6, 2017 Accepting new patients
Port City Operating Company, LLC CurrentSince Sep 6, 2017 Accepting new patients
Sacramento Native American Health Center Inc CurrentSince Feb 4, 2024 Accepting new patients
Sacramento Native American Health Center, Inc. PastSince Feb 4, 2024 Accepting new patients
Fig Tree Psychology Center Past Accepting new patients

Locations

2020 J St
Sacramento, CA 95811
Phone (916) 341-0575

3800 Florin Rd
Sacramento, CA 95823
Phone (916) 341-0575

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

2510 N California St
Stockton, CA 95204
Phone (209) 461-2000

510 E Magnolia St
Ste 100
Stockton, CA 95202
Phone (209) 938-0831

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1326262486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 W ROBINHOOD DR STE A8",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075625",
            "telephone_number": "209-607-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 W ROBINHOOD DR STE A8",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075625",
            "telephone_number": "209-607-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAOANG-WELSH",
        "first_name": "CATHY",
        "middle_name": "DINICE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS29035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.