Individual provider Active NPI

Tameika Timmons, LCSW

  • Clinical Social Worker
  • Tustin, CA
National Provider Identifier
1326283557
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 74176 Issued in CA
Practice address
1 Hope Dr
Tustin, CA 92782-0221
Phone
(714) 247-0300
Fax
(714) 259-1598
NPI assigned
Dec 2, 2008
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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 LCSW 74176 CA Primary

Addresses

Primary practice location

1 Hope Dr
Tustin, CA 92782-0221

Mailing address

1 Hope Dr
Tustin, CA 92782-0221
Phone (714) 247-0300

Other practice location 1

947 S Anaheim Blvd Ste 260
Anaheim, CA 92805-5591
Phone (714) 247-0300

Other practice location 2

1100B N Tustin Ave # A
Santa Ana, CA 92705-3505
Phone (714) 247-0300

Other practice location 3

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

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
I20161128002744 CA Practitioner - Clinical Social Worker 9739468224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurtt Family Health Clinic IncGroup PAC ID 4183764814, 2 clinicians

Practice addresses (Care Compare)

1 Hope Dr
Tustin, CA 92782-0221
Phone 71424703002000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 74176CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hurtt Family Health Clinic Inc. CurrentSince Feb 3, 2021 Accepting new patients
Hurtt Family Health Clinic Inc. CurrentSince Feb 3, 2021 Accepting new patients

Locations

947 S Anaheim Blvd
Ste 260
Anaheim, CA 92805

1100 N Tustin Ave
Ste A
Santa Ana, CA 92705
Phone (714) 835-6055

1 Hope Dr
Tustin, CA 92782
Phone (714) 247-4398

1 Hope Dr
Ste B
Tustin, CA 92782

Organizations & group practices 2

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": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1326283557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100B N Tustin Ave # A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 S Beaudry Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171466",
            "country_code": "US",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "TAMEIKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 74176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.