Active NPI
Lynda S. Hiatt, LCSW
- Clinical Social Worker
- Wildomar, CA
National Provider Identifier
1639110364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS14784
- Practice address
- 35524 Parkwood CT
Wildomar, CA 92595 - Phone
- (760) 468-6180
- Fax
- (951) 677-6712
- NPI assigned
- Jun 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1236943501 | UT | |
| Clinical Social Worker | 1041C0700X | LCS14784 | CA | Primary |
Addresses
Primary practice location
35524 Parkwood CT
Wildomar, CA 92595
Mailing address
35524 Parkwood CT
Wildomar, CA 92595-7706
Phone (760) 468-6180
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220621002157 | CA | Practitioner - Clinical Social Worker | 5294707626 | Practice locations: Wildomar, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS14784 | CA | MD | Clinical Social Worker |
| 1236943501 | UT | MD | Clinical Social Worker |
| 14784 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1639110364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35524 PARKWOOD CT",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "925957706",
"telephone_number": "760-468-6180",
"fax_number": "951-677-6712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35524 PARKWOOD CT",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "92595",
"telephone_number": "760-468-6180",
"fax_number": "951-677-6712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIATT",
"first_name": "LYNDA",
"middle_name": "S.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "1236943501",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS14784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wildomar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.