Active NPI
Sara Marie Chleboun
- Social Worker
- Garden Grove, CA
National Provider Identifier
1558036087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109299
- Practice address
- 12966 Euclid St Ste 280
Garden Grove, CA 92840-9202 - Phone
- (657) 251-9912
- Fax
- (714) 823-4777
- NPI assigned
- Aug 16, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 109299 | CA | Primary |
Addresses
Primary practice location
12966 Euclid St Ste 280
Garden Grove, CA 92840-9202
Mailing address
12966 Euclid St Ste 280
Garden Grove, CA 92840-9202
Phone (657) 251-9912
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109299 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686268800000",
"number": "1558036087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12966 EUCLID ST STE 280",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928409202",
"telephone_number": "657-251-9912",
"fax_number": "714-823-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12966 EUCLID ST STE 280",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928409202",
"telephone_number": "657-251-9912",
"fax_number": "714-823-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHLEBOUN",
"first_name": "SARA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-16",
"last_updated": "2023-06-09",
"certification_date": "2023-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "109299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.