Individual provider Active NPI

Karen Koch, L,C,S,W., PSY.D.

  • Clinical Social Worker
  • Encino, CA
National Provider Identifier
1679791602
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 12337 Issued in CA
Practice address
16055 Ventura Blvd
Suite 1110
Encino, CA 91436-2601
Phone
(818) 704-9262
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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 LCS 12337 CA Primary

Addresses

Primary practice location

16055 Ventura Blvd
Suite 1110
Encino, CA 91436-2601

Mailing address

16055 Ventura Blvd
Suite 1110
Encino, CA 91436-2601
Phone (818) 704-9262

Other identifiers 1

IdentifierTypeStateIssuer
148862OtherCAVALUE OPTIONS

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
I20100619000163 CA Practitioner - Clinical Social Worker 9133259088 Practice locations: Los Angeles, CA; Woodland Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21901 Burbank Blvd
Unit 166
Woodland Hills, CA 91367-6427
Phone (818) 704-9262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 12337CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1679791602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "SUITE 1110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362601",
            "telephone_number": "818-704-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "SUITE 1110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362601",
            "telephone_number": "818-704-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KAREN",
        "credential": "L,C,S,W., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 12337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "148862",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.