Divora Wilma Stern, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20498 Issued in CA

Practice address

175 S Humboldt St
Willits, CA 95490-3511

Phone

(707) 354-9911

NPI assigned

Apr 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689891327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5975 TARTAR CANYON RD",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954909203",
            "telephone_number": "707-459-9052",
            "fax_number": "707-459-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S HUMBOLDT ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903511",
            "telephone_number": "707-354-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "DIVORA",
        "middle_name": "WILMA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane L Smalley, L.AC.
• Carolyn Jeanne Smith, MFT
• Peter J. Smith
• Taya Smith
• Abbie Gayle Stephens, PPS
• Stephanie Strickland, FNP-BC/C, RN, MSN
• Larry D Sullivan, DDS
• Tapestry Family Services
• Tapestry Family Services, Inc.
• Carly Rose Taylor

• Clinical Social Worker in Willits, CA
• Providers in Willits, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.