Active NPI
Simmone Kaoru Okamoto
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1669248043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- BACB832629
- Practice address
- 8100 Truxton Ave
Los Angeles, CA 90045-2925 - Phone
- (310) 880-2968
- NPI assigned
- Nov 28, 2023
- Sex
- Female
- 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 | BACB832629 | CA | Primary |
Addresses
Primary practice location
8100 Truxton Ave
Los Angeles, CA 90045-2925
Mailing address
8100 Truxton Ave
Los Angeles, CA 90045-2925
Phone (310) 880-2968
Other practice location 1
350 45th St S
Fargo, ND 58103
Phone (310) 880-2968
Other practice location 2
100 Universal City Plz
Universal City, CA 91608-1002
Phone (310) 880-2968
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sanford.html |
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB832629 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1669248043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 TRUXTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900452925",
"telephone_number": "310-880-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 TRUXTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900452925",
"telephone_number": "310-880-2968"
}
],
"practiceLocations": [
{
"address_1": "350 45th St S",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "58103",
"country_code": "US",
"telephone_number": "310-880-2968",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Universal City Plz",
"address_purpose": "LOCATION",
"city": "Universal City",
"state": "CA",
"postal_code": "916081002",
"country_code": "US",
"telephone_number": "310-880-2968",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OKAMOTO",
"first_name": "SIMMONE",
"middle_name": "KAORU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-28",
"last_updated": "2023-11-28",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "BACB832629",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sanford.html",
"affiliation": "N",
"address_1": "8100 Truxton Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900452925",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.