Traci Keiko Ishigo, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

83877 Issued in CA

Practice address

3371 Glendale Blvd Ste 214
Los Angeles, CA 90039-1857

Phone

(562) 661-9813

NPI assigned

Jan 22, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1497385199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 GLENDALE BLVD STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 GLENDALE BLVD STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391857",
            "telephone_number": "562-661-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIGO",
        "first_name": "TRACI",
        "middle_name": "KEIKO",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "traci@grazelgarciatherapy.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3371 Glendale Blvd Ste 214",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900391857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• April Iser
• Abraham M Ishaaya, M.D.
• Nicole Frances Isham, MSN, PMHNP
• Megan Ishibashi, DPM
• Rebecca Kimiko Ishida, MFT
• Kristen Ishii
• Shinya Ishii, M.D.
• David Ishimitsu, M.D.
• Mariko Ishimori, M.D.
• Cara Ishisaka

• All providers in Los Angeles, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.