Individual provider Active NPI

Shamaine C Ford, LCSW

  • Clinical Social Worker
  • Compton, CA
National Provider Identifier
1477221273
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
102679 Issued in CA
Practice address
701 S Clymar Ave
Compton, CA 90220-3323
Phone
(310) 613-8131
NPI assigned
Sep 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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 102679 CA Primary

Addresses

Primary practice location

701 S Clymar Ave
Compton, CA 90220-3323

Mailing address

701 S Clymar Ave
Compton, CA 90220-3323
Phone (310) 613-8131

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
102679CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1477221273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S CLYMAR AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203323",
            "telephone_number": "310-613-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S CLYMAR AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203323",
            "telephone_number": "310-613-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SHAMAINE",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-06",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2021; 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.