Individual provider Active NPI

Patricia C Poblete, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1356490684
Registry record updated Oct 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8784-C Issued in NV
Practice address
1809 Snow Spring LN
Las Vegas, NV 89134-2551
Phone
(725) 270-7759
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27602 CA
Clinical Social Worker 1041C0700X 8784-C NV Primary

Addresses

Primary practice location

1809 Snow Spring LN
Las Vegas, NV 89134-2551

Mailing address

1930 Village Center Cir # 3239
Las Vegas, NV 89134-6299
Phone (510) 224-0103

Other identifiers 2

IdentifierTypeStateIssuer
27602OtherCABBS
8784-COtherNVSTATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS

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

LicenseStateTypeSpecialty
8784-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1356490684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 VILLAGE CENTER CIR # 3239",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346299",
            "telephone_number": "510-224-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 SNOW SPRING LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891342551",
            "telephone_number": "725-270-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27602",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "8784-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "27602",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS",
            "identifier": "8784-C",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2022; 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.