Thidar Moldin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27038 Issued in CA

Practice address

12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331

Phone

(818) 896-1161

Fax

(818) 896-5069

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1649397100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD STE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311393",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD STE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "91331",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 W Vernon Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900372700",
            "country_code": "US",
            "telephone_number": "323-474-0430",
            "fax_number": "323-232-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLDIN",
        "first_name": "THIDAR",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6758",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Pacoima, CA
• Providers in Pacoima, 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 Mar 26, 2019; 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.