Individual provider Active NPI

Chandra Monique Williams

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1437297843
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS17092 Issued in CA
Practice address
3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone
(323) 751-3026
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 LCS17092 CA Primary

Addresses

Primary practice location

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821

Mailing address

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-4525

Other practice location 1

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Phone (510) 248-5735

Other practice location 2

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-4525

Other practice location 3

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone (323) 751-3026

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
LCS17092CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Health & Rehabilitation Program PastSince Jan 21, 2022 Accepting new patients

Organizations & group practices 1

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1437297843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "323-751-3026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39400 Paseo Padre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945382310",
            "country_code": "US",
            "telephone_number": "510-248-5735",
            "fax_number": "510-248-3466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624284",
            "country_code": "US",
            "telephone_number": "310-627-4525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 Crenshaw Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900081821",
            "country_code": "US",
            "telephone_number": "323-751-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CHANDRA",
        "middle_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS17092",
            "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 Jan 14, 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.

Verify at the official NPI Registry.