Individual provider Active NPI

Regina An

  • Clinical Social Worker
  • Alhambra, CA
National Provider Identifier
1487848164
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS26730 Issued in CA
Practice address
1515 W Mission Rd
Alhambra, CA 91803
Phone
(626) 943-3416
NPI assigned
Sep 5, 2007
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 LCS26730 CA Primary

Addresses

Primary practice location

1515 W Mission Rd
Alhambra, CA 91803

Mailing address

1515 W Mission Rd
Alhambra, CA 91803-1618
Phone (626) 943-3416

Other practice location 1

66 Hurlbut St
Pasadena, CA 91105-4025
Phone (626) 441-4221

Other identifiers 1

IdentifierTypeStateIssuer
ICAN773OtherCADMH STAFF CODE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS26730CAMDClinical Social Worker
26730CAMDOccupational Health Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1487848164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W MISSION RD",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918031618",
            "telephone_number": "626-943-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W MISSION RD",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "91803",
            "telephone_number": "626-943-3416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Hurlbut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911054025",
            "country_code": "US",
            "telephone_number": "626-441-4221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AN",
        "first_name": "REGINA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS26730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMH STAFF CODE",
            "identifier": "ICAN773",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.