Active NPI
David Calvillo, LCSW
- Clinical Social Worker
- Fullerton, CA
National Provider Identifier
1639489248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 68678
- Practice address
- 3607 W Valencia Dr
Fullerton, CA 92833-3134 - Phone
- (714) 458-4982
- NPI assigned
- Oct 15, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 68678 | CA | Primary |
Addresses
Primary practice location
3607 W Valencia Dr
Fullerton, CA 92833-3134
Mailing address
2311 W El Segundo Blvd
Hawthorne, CA 90250-3315
Phone (323) 241-6730
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68678 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1639489248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2311 W EL SEGUNDO BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902503315",
"telephone_number": "323-241-6730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3607 W VALENCIA DR",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928333134",
"telephone_number": "714-458-4982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALVILLO",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-15",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "68678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.