Individual provider Active NPI

Veronica Real, LCSW

  • Clinical Social Worker
  • Santa Monica, CA
National Provider Identifier
1639312176
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23617 Issued in CA
Practice address
610 Santa Monica Blvd Ste 209
Santa Monica, CA 90401-1646
Phone
(310) 869-5021
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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 23617 CA Primary

Addresses

Primary practice location

610 Santa Monica Blvd Ste 209
Santa Monica, CA 90401-1646

Mailing address

2457 Federal Ave
Los Angeles, CA 90064-2915
Phone (310) 869-5021

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

LicenseStateTypeSpecialty
23617CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1639312176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 FEDERAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642915",
            "telephone_number": "310-869-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SANTA MONICA BLVD STE 209",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011646",
            "telephone_number": "310-869-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAL",
        "first_name": "VERONICA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "23617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; 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.