Andre Ricardo Vaz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9676 Issued in FL

Practice address

PO Box 555191
Camp Pendleton, CA 92055-5191

Phone

(760) 719-3312

NPI assigned

Mar 23, 2010

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1619291440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-719-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-719-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZ",
        "first_name": "ANDRE",
        "middle_name": "RICARDO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2024-05-09",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anand B Valathur, PHARMD
• Jennifer Vale Cruz, D.M.D
• Kelsey Christine Van Bokkem, DO
• Zachary Vano, PT, DPT
• Tricia Elaine Vanwagner, M.D.
• Leslie Y Vazquez, LCSW
• Jaime Vega, D.O., M.P.H.
• Michelle Juanita Vega
• Travis Jonathan Vertolli, DMD
• Alexander Joseph Vidunas

• Clinical Social Worker in Camp Pendleton, CA
• Providers in Camp Pendleton, 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 May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.