Individual provider Active NPI

Andrew Robert Dodd, LCSW

  • Clinical Social Worker
  • Corona, CA
National Provider Identifier
1508204918
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 20340 Issued in CA
Practice address
16756 Chino Corona Rd
Corona, CA 92880-1700
Phone
(909) 597-1771
Fax
(909) 393-6864
NPI assigned
Jun 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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 LCS 20340 CA Primary

Addresses

Primary practice location

16756 Chino Corona Rd
Corona, CA 92880-1700

Mailing address

16756 Chino Corona Rd
Corona, CA 92880-9508
Phone (909) 597-1771

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

LicenseStateTypeSpecialty
LCS 20340CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of California Past Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1508204918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16756 CHINO CORONA RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928809508",
            "telephone_number": "909-597-1771",
            "fax_number": "909-393-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16756 CHINO CORONA RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801700",
            "telephone_number": "909-597-1771",
            "fax_number": "909-393-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "ANDREW",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 20340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.