Active NPI
Sanjay V. Shah, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1487735825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17375
- Practice address
- 550 S Vermont Ave FL 10
Los Angeles, CA 90020-1912 - Phone
- (626) 258-3022
- Fax
- (562) 868-3749
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17375 | CA | Primary |
Addresses
Primary practice location
550 S Vermont Ave FL 10
Los Angeles, CA 90020-1912
Mailing address
550 S Vermont Ave FL 10
Los Angeles, CA 90020-1912
Phone (626) 258-3022
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17375 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1487735825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE FL 10",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "626-258-3022",
"fax_number": "562-868-3749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE FL 10",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "626-258-3022",
"fax_number": "562-868-3749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "SANJAY",
"middle_name": "V.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "17375",
"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 Mar 30, 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.