Kathleen Judith Baca Leanos

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

98974 Issued in CA

Practice address

1911 Williams Dr
Oxnard, CA 93036-2612

Phone

(661) 510-2423

NPI assigned

Aug 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tierra Luz Community Practice, License Clinical Social Worker, a Professional Corporation

  • Clinical Social Worker
  • Oxnard, CA
  • NPI 1972478170
  NPD Authorized official
• High Desert Psychological Services

  • Psychologist
  • Victorville, CA
  • NPI 1104463371

  Clinical

  NPD

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1386043370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362612",
            "telephone_number": "661-510-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362612",
            "telephone_number": "661-510-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA LEANOS",
        "first_name": "KATHLEEN",
        "middle_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "98974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mally Azarmipur, O.D.
• Farid Azhar, DDS
• Lisa Louise Babashoff, M.D.
• John Tyler Baber Jr., M.D.
• Colleen Mary Babineau, MSW
• Myhang Bach, PHARMACIST
• Keegan Bachelor
• Tamara Lynn Backer, M.S. CCC-SLP
• Mara Bactad, FNP-CB
• Gabriela Baez

• Clinical Social Worker in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.