Individual provider Active NPI

James Hernan Triana Jr., PH.D., L.C.S.W.

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1467649244
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW00004279 Issued in FL
Practice address
7369 Sheridan St
Hollywood, FL 33024-2776
Phone
(954) 663-1837
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 SW00004279 FL Primary

Addresses

Primary practice location

7369 Sheridan St
Hollywood, FL 33024-2776

Mailing address

9000 Jacaranda LN
Suite 104
Plantation, FL 33324-3600
Phone (954) 663-1837

Other identifiers 1

IdentifierTypeStateIssuer
Z7123OtherFLBLUECROSS/BLUESHIELD

Other names 1

  • Dr. Santiago Hernan Triana Jr. Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040212000255 FL Practitioner - Clinical Social Worker 9234023987 Practice locations: Plantation, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SW00004279FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1467649244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 JACARANDA LN",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243600",
            "telephone_number": "954-663-1837",
            "fax_number": "954-473-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7369 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242776",
            "telephone_number": "954-663-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIANA",
        "first_name": "JAMES",
        "middle_name": "HERNAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW00004279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "Z7123",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANTIAGO",
            "last_name": "TRIANA",
            "middle_name": "HERNAN",
            "prefix": "DR.",
            "suffix": "JR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.