Individual provider Active NPI

Asianna Luong Khong

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1477015089
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125291 Issued in CA
Practice address
233 S Quintana Dr
Anaheim, CA 92807-4029
Phone
(714) 988-9822
NPI assigned
Apr 2, 2019
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 125291 CA Primary

Addresses

Primary practice location

233 S Quintana Dr
Anaheim, CA 92807-4029

Mailing address

233 S Quintana Dr
Anaheim, CA 92807-4029
Phone (714) 988-9822

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
I20241226002154 CA Practitioner - Clinical Social Worker 8325575665 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125291CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Individual & Family Counseling Inc CurrentSince Dec 20, 2024 Accepting new patients

Locations

2716 S Vermont Ave
Ste 9
Los Angeles, CA 90007
Phone (323) 810-9233

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1477015089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S QUINTANA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074029",
            "telephone_number": "714-988-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S QUINTANA DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074029",
            "telephone_number": "714-988-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHONG",
        "first_name": "ASIANNA",
        "middle_name": "LUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.