Individual provider Active NPI

Calvin Wheeler Prather, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1629185145
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS10519 Issued in CA
Practice address
3511 Camino del Rio South
Suite 500
San Diego, CA 92108-4022
Phone
(619) 282-4600
Fax
(619) 624-0178
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS10519 CA Primary

Addresses

Primary practice location

3511 Camino del Rio South
Suite 500
San Diego, CA 92108-4022

Mailing address

3511 Camino del Rio South
Suite 500
San Diego, CA 92108-4022
Phone (619) 282-4600

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS10519CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1629185145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 CAMINO DEL RIO SOUTH",
            "address_2": "SUITE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084022",
            "telephone_number": "619-282-4600",
            "fax_number": "619-624-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 CAMINO DEL RIO SOUTH",
            "address_2": "SUITE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084022",
            "telephone_number": "619-282-4600",
            "fax_number": "619-624-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATHER",
        "first_name": "CALVIN",
        "middle_name": "WHEELER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS10519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.