Active NPI
Victoria Smith, LCSW
- Clinical Social Worker
- Hermosa Beach, CA
National Provider Identifier
1689337016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104872
- Practice address
- 2615 Pacific Coast Hwy Ste 324
Hermosa Beach, CA 90254-2227 - Phone
- (424) 253-5781
- NPI assigned
- Oct 21, 2021
- 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 | 104872 | CA | Primary |
Addresses
Primary practice location
2615 Pacific Coast Hwy Ste 324
Hermosa Beach, CA 90254-2227
Mailing address
413 Richmond Street
1/2
El Segundo, CA 90245
Phone (310) 848-5922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104872 | Other | CA | LICENSED CLINICAL SOCIAL WORKER |
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 |
|---|---|---|---|
| 104872 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1689337016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 RICHMOND STREET",
"address_2": "1/2",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "90245",
"telephone_number": "310-848-5922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 PACIFIC COAST HWY STE 324",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902542227",
"telephone_number": "424-253-5781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "VICTORIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-21",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "104872",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CLINICAL SOCIAL WORKER",
"identifier": "104872",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hermosa Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.