Individual provider Active NPI

Tamara Wynona Wyant, ASW

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1497872691
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
79834 Issued in CA
Practice address
921 W Avenue J
Lancaster, CA 93534-3443
Phone
(661) 341-3052
Fax
(661) 729-8912
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 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 79834 CA Primary

Addresses

Primary practice location

921 W Avenue J
Lancaster, CA 93534-3443

Mailing address

921 W Avenue J
Lancaster, CA 93534-3443
Phone (661) 341-3052

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
I20200623002039 CA Practitioner - Clinical Social Worker 9739501644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1497872691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343443",
            "telephone_number": "661-341-3052",
            "fax_number": "661-729-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343443",
            "telephone_number": "661-341-3052",
            "fax_number": "661-729-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYANT",
        "first_name": "TAMARA",
        "middle_name": "WYNONA",
        "name_prefix": "Mrs.",
        "credential": "ASW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.