Individual provider Active NPI

Javanne Golob, LCSW

  • Clinical Social Worker
  • Venice, CA
National Provider Identifier
1356863013
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
77915 Issued in CA
Practice address
237 4TH Ave Apt B2
Venice, CA 90291-8651
Phone
(424) 835-1495
Fax
(424) 835-1495
NPI assigned
Jul 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 77915 CA Primary

Addresses

Primary practice location

237 4TH Ave Apt B2
Venice, CA 90291-8651

Mailing address

707 Coeur D Alene Ave
Venice, CA 90291-4924
Phone (702) 340-9799

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
77915CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1356863013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 COEUR D ALENE AVE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902914924",
            "telephone_number": "702-340-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 4TH AVE APT B2",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902918651",
            "telephone_number": "424-835-1495",
            "fax_number": "424-835-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOB",
        "first_name": "JAVANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.