Individual provider Active NPI

Tika Shoulders

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1558729699
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW111173 Issued in CA
Practice address
626 W Lancaster Blvd # 90
Lancaster, CA 93534-3108
Phone
(661) 674-6438
NPI assigned
Feb 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X LCSW111173 CA Primary

Addresses

Primary practice location

626 W Lancaster Blvd # 90
Lancaster, CA 93534-3108

Mailing address

PO Box 2292
Lancaster, CA 93539-2292
Phone (661) 674-6438

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
I20240920001324 CA Practitioner - Clinical Social Worker 1456892298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW111173CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Jul 12, 2024 Accepting new patients
Shoulders to Lean on Inc. Clinical CurrentSince Mar 17, 2024 Accepting new patients
JWCH Institute Inc CurrentSince Jul 12, 2024 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

45104 10th St W
Lancaster, CA 93534
Phone (661) 941-9543

626 W Lancaster Blvd
Lancaster, CA 93534
Phone (661) 220-9977

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Interoperability endpoints

  • Direct secure messaging: tika.shoulderslcsw.p1@direct.jwch.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1558729699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2292",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392292",
            "telephone_number": "661-674-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W LANCASTER BLVD # 90",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343108",
            "telephone_number": "661-674-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "TIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW111173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.