Individual provider Active NPI

Erika Chantal Allen-Andere, LCSW

  • Clinical Social Worker
  • Newport Beach, CA
National Provider Identifier
1659757391
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW90753 Issued in CA
Practice address
4685 Macarthur CT Ste 340
Newport Beach, CA 92660-1855
Phone
(888) 684-2779
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 71472 CA
Clinical Social Worker 1041C0700X LCSW90753 CA Primary

Addresses

Primary practice location

4685 Macarthur CT Ste 340
Newport Beach, CA 92660-1855

Mailing address

4685 Macarthur CT Ste 340
Newport Beach, CA 92660-1855
Phone (888) 684-2779

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200427002482 CA Practitioner - Clinical Social Worker 4486084886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2271 Alpine Blvd
Suite a
Alpine, CA 91901-1101
Phone (619) 448-1216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 71472CAMDClinical Social Worker
LCSW90753CAMDClinical Social Worker
90573CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation CurrentSince Apr 20, 2020 Accepting new patients
Fusion Care Group, a Psychological Professional Corporation CurrentSince May 1, 2021 Accepting new patients

Locations

2271 Alpine Blvd
Ste A
Alpine, CA 91901
Phone (619) 289-7322

23421 S Pointe Dr
Ste 290
Laguna Hills, CA 92653
Phone (949) 322-4061

4685 MacArthur Ct
Ste 340
Newport Beach, CA 92660
Phone (949) 424-4544

2124 S El Camino Real
Ste 101
Oceanside, CA 92054
Phone (760) 405-4787

3511 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 289-7322

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1659757391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 MACARTHUR CT STE 340",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601855",
            "telephone_number": "888-684-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 MACARTHUR CT STE 340",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601855",
            "telephone_number": "888-684-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-ANDERE",
        "first_name": "ERIKA",
        "middle_name": "CHANTAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 71472",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW90753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.