Individual provider Active NPI

Staci Lyn Ashby

  • Clinical Social Worker
  • West Covina, CA
National Provider Identifier
1407364128
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128608 Issued in CA
Practice address
2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545
Phone
(626) 489-9144
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 128608 CA Primary

Addresses

Primary practice location

2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545

Mailing address

2155 E Garvey Ave N Ste B17
West Covina, CA 91791-1545
Phone (626) 489-9144

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
I20250821003065 CA Practitioner - Clinical Social Worker 4183124480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2155 E Garvey Ave N
Suite B17
West Covina, CA 91791-1545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
128608CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Through the Sea Marriage and Family Counseling Inc Clinical CurrentSince Aug 6, 2025 Accepting new patients
Child Guidance Center, Inc. Past Accepting new patients
Descanso Home Health Services PastSince Aug 6, 2025 Accepting new patients

Locations

2155 E Garvey Ave N
Ste B17
West Covina, CA 91791
Phone (626) 489-9114

Organizations & group practices 3

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1407364128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E GARVEY AVE N STE B17",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911545",
            "telephone_number": "626-489-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E GARVEY AVE N STE B17",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911545",
            "telephone_number": "626-489-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHBY",
        "first_name": "STACI",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "128608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.