Individual provider Active NPI

Pamela G. Jordan, L.C.S.W.

  • Clinical Social Worker
  • Santa Maria, CA
National Provider Identifier
1528255403
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS5700 Issued in CA
Practice address
301 E Cook St Ste K
Santa Maria, CA 93454-5134
Phone
(909) 762-1694
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCS5700 CA Primary

Addresses

Primary practice location

301 E Cook St Ste K
Santa Maria, CA 93454-5134

Mailing address

1611 Via Sabroso
Santa Maria, CA 93454-2613
Phone (909) 762-1694

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
I20160912000078 CA Practitioner - Clinical Social Worker 1153617519 Practice locations: Santa Maria, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1101 S Broadway
Santa Maria, CA 93454-6660
Phone (909) 762-1694

301 E Cook St
Suite G1
Santa Maria, CA 93454-5134
Phone (909) 762-1694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS5700CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County Auditor Past Accepting new patients

Organizations & group practices 1

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1528255403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 VIA SABROSO",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934542613",
            "telephone_number": "909-762-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E COOK ST STE K",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545134",
            "telephone_number": "909-762-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "PAMELA",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "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": "LCS5700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.