Individual provider Active NPI

Rebecca Park-Hem

  • Clinical Social Worker
  • Garden Grove, CA
National Provider Identifier
1376279935
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW121565 Issued in CA
Practice address
12912 Brookhurst St Ste 400
Garden Grove, CA 92840-4883
Phone
(844) 430-0240
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA
Clinical Social Worker 1041C0700X LCSW121565 CA Primary
Case Manager/Care Coordinator 171M00000X CA

Addresses

Primary practice location

12912 Brookhurst St Ste 400
Garden Grove, CA 92840-4883

Mailing address

12912 Brookhurst St Ste 400
Garden Grove, CA 92840-4883
Phone (844) 430-0240

Other practice location 1

1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5101

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
I20260407002522 CA Practitioner - Clinical Social Worker 2567937535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 W Ctr St Promenade
Anaheim, CA 92805-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW121565CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Asian and Pacific Islander Community Alliance, Inc. CurrentSince Jun 8, 2025 Accepting new patients

Locations

12912 Brookhurst St
Ste 400
Garden Grove, CA 92840
Phone (714) 636-9095

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1376279935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 BROOKHURST ST STE 400",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404883",
            "telephone_number": "844-430-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12912 BROOKHURST ST STE 400",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404883",
            "telephone_number": "844-430-0240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1835 Sunny Crest Dr",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353616",
            "country_code": "US",
            "telephone_number": "714-446-5101",
            "fax_number": "714-871-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK-HEM",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW121565",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.