Active NPI
Tatiana Caicedo, LCSW
- Clinical Social Worker
- Tustin, CA
National Provider Identifier
1508359167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW101789
- Practice address
- 621 W 1St St
Tustin, CA 92780-2950 - Phone
- (714) 665-9890
- Fax
- (714) 665-9891
- NPI assigned
- Jun 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | LCSW101789 | CA | Primary |
Addresses
Primary practice location
621 W 1St St
Tustin, CA 92780-2950
Mailing address
3540 Howard Way Ste 150
Costa Mesa, CA 92626-1496
Other practice location 1
9918 Katella Ave Ste A-C
Anaheim, CA 92804-6465
Phone (714) 968-6789
Other practice location 2
11180 Warner Ave Ste 353
Fountain Valley, CA 92708-7516
Phone (714) 968-6789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW101789 | CA | MD | Clinical Social Worker |
| 101789 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Families Together of Orange County | Past | Accepting new patients | |
| Orange County Association for Mental Health | Mental Health | Past | Accepting new patients |
| Orange County Association for Mental Health | Mental Health | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Tustin, CA
- NPI 1114788239
-
- Mental Health Counselor
- Santa Ana, CA
- NPI 1316076151
-
- Mental Health Counselor
- Costa Mesa, CA
- NPI 1972632610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761177600000",
"number": "1508359167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 HOWARD WAY STE 150",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926261496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 W 1ST ST",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927802950",
"telephone_number": "714-665-9890",
"fax_number": "714-665-9891"
}
],
"practiceLocations": [
{
"address_1": "9918 Katella Ave Ste A-C",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928046465",
"country_code": "US",
"telephone_number": "714-968-6789",
"fax_number": "714-202-2626",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11180 Warner Ave Ste 353",
"address_purpose": "LOCATION",
"city": "Fountain Valley",
"state": "CA",
"postal_code": "927087516",
"country_code": "US",
"telephone_number": "714-968-6789",
"fax_number": "714-202-2626",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAICEDO",
"first_name": "TATIANA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW101789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.