Individual provider Active NPI

Bonnie Kamp, LCSW

  • Clinical Social Worker
  • North Hills, CA
National Provider Identifier
1689845307
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS18862 Issued in CA
Practice address
15206 Parthenia St
North Hills, CA 91343-5305
Phone
(818) 895-3100
Fax
(818) 892-3352
NPI assigned
Mar 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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 LCS18862 CA Primary

Addresses

Primary practice location

15206 Parthenia St
North Hills, CA 91343-5305

Mailing address

15206 Parthenia St
North Hills, CA 91343-5305
Phone (818) 895-3100

Other identifiers 4

IdentifierTypeStateIssuer
FHC70436FMedicaidCA
EAP70436FMedicaidCA
HAP70436FMedicaidCA
W11698OtherCAGROUP ID

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
I20210630002348 CA Practitioner - Clinical Social Worker 7315374790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18862CAMDAddiction (Substance Use Disorder) Counselor
LCS18862CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Jun 30, 2021 Accepting new patients
Mission City Community Network, Inc. CurrentSince Jun 30, 2021 Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
Mission City Community Network,Inc Past Accepting new patients

Locations

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

15206 Parthenia St
Sepulveda, CA 91343

Organizations & group practices 4

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": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1689845307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15206 PARTHENIA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435305",
            "telephone_number": "818-895-3100",
            "fax_number": "818-892-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15206 PARTHENIA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435305",
            "telephone_number": "818-895-3100",
            "fax_number": "818-892-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMP",
        "first_name": "BONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70436F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EAP70436F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP70436F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID",
            "identifier": "W11698",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hills, CA

Sources for this page

Verify at the official NPI Registry.