Elaine Kathryn Dern, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21607 Issued in CA

Practice address

16585 Pacific Coast Hwy
Suite 202
Sunset Beach, CA 90742

Phone

(714) 595-0606

NPI assigned

Jun 3, 2013

Last updated

Jun 3, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1518304302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8502 E CHAPMAN AVE",
            "address_2": "SUITE 113",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928692461",
            "telephone_number": "714-595-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16585 PACIFIC COAST HWY",
            "address_2": "SUITE 202",
            "city": "SUNSET BEACH",
            "state": "CA",
            "postal_code": "90742",
            "telephone_number": "714-595-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERN",
        "first_name": "ELAINE",
        "middle_name": "KATHRYN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Paige Alonso, N.P.
• Beyond Healthcare Holdings, LLC
• Kimberly Michelle Cowley, FNP
• Derm Effects Inc. (Dermfx)
• Elizabeth Ann Derry
• Roula Germain, MA
• Kindah Nackoud, PA-C
• Crystal Nguyen, CERTIFIED MASSAGE
• Kathryn Richey

• Clinical Social Worker in Sunset Beach, CA
• Providers in Sunset Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.

Verify at the official NPI Registry.