Active NPI
Timothy Lin
- Clinical Social Worker
- Pacoima, CA
National Provider Identifier
1619256146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 73545
- Practice address
- 12450 Van Nuys Blvd Ste 100
Pacoima, CA 91331-1392 - Phone
- (626) 395-7100
- NPI assigned
- Aug 15, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 33569 | CA | |
| Clinical Social Worker | 1041C0700X | 73545 | CA | Primary |
Addresses
Primary practice location
12450 Van Nuys Blvd Ste 100
Pacoima, CA 91331-1392
Mailing address
12510 Van Nuys Blvd
Pacoima, CA 91331-1338
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 |
|---|---|---|---|
| 73545 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1619256146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12510 VAN NUYS BLVD",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913311338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12450 VAN NUYS BLVD STE 100",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913311392",
"telephone_number": "626-395-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-15",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "33569",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "73545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacoima, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.