Shorena Alexander, LCSW
Individual provider Active NPI Clinical Social Worker · Los Angeles, CA
NPI 1508128166 · NPPES record last updated Jun 11, 2012
Key facts
- NPI
- 1508128166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS28595 (CA)
- Practice address
- 4311 Wilshire Blvd
Apt 211
Los Angeles, CA 90010-3708 - Phone
- (310) 247-0864
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1626 N Poinsettia PL
Apt 306
Los Angeles, CA 90046-3971
Phone (323) 683-0801
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121017000376 | CA | Practitioner - Clinical Social Worker | 5597915132 | Practice locations: Los Angeles, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS28595 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS28595 | CA | Yes |
Addresses
Primary practice location
4311 Wilshire Blvd
Apt 211
Los Angeles, CA 90010-3708
Mailing address
4311 Wilshire Blvd
Apt 211
Los Angeles, CA 90010-3708
Phone (310) 247-0864
Other names
- Shorena Chakvetazde
Other providers in Los Angeles, CA
- Regina Lynn Alexander
- Russel Hashimy Alexander
- Sabrina Anasa Alexander
- Shiquita Alexander
- Shirley J. Alexander
- Tarquin Dillon Alexander
- Terrence Fitzgerald Alexander
- Tianee Alexander
- Twanisha Grace Renee Alexander
- Wednesday Alexander
All providers in Los Angeles, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.