Active NPI
Kellie Vaca
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1396294591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 83763
- Practice address
- 7120 Franklin Ave
Los Angeles, CA 90046-3002 - Phone
- (323) 876-0550
- NPI assigned
- Sep 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 83763 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 83763 | CA | Primary |
Addresses
Primary practice location
7120 Franklin Ave
Los Angeles, CA 90046-3002
Mailing address
10155 Colima Rd
Whittier, CA 90603-2042
Phone (562) 692-0383
Other practice location 1
855 N Orange Grove Blvd
Pasadena, CA 91103-3333
Phone (626) 796-3453
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
| License | State | Type | Specialty |
|---|---|---|---|
| 83763 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646870400000",
"number": "1396294591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10155 COLIMA RD",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906032042",
"telephone_number": "562-692-0383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7120 FRANKLIN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900463002",
"telephone_number": "323-876-0550"
}
],
"practiceLocations": [
{
"address_1": "855 N Orange Grove Blvd",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911033333",
"country_code": "US",
"telephone_number": "626-796-3453",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VACA",
"first_name": "KELLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "83763",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "83763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.