Angie Y. Main, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00306046 Issued in CA

Practice address

1031 Waterloo Rd
Stockton, CA 95205-4256

Phone

(209) 940-5662

NPI assigned

Apr 4, 2014

Last updated

Dec 13, 2023By 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 2

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angie.ybarrarojas.p1@direct.cmcentersinc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Medical Centers, Inc.

  dba Esparto Family Practice

  • Federally Qualified Health Center (FQHC)
  • Esparto, CA
  • NPI 1588729180
  Medicare reassignment NPD
• Community Medical Centers Inc

  dba Community Medical Centers, Lodi East

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1891529061
  NPD
• Community Medical Centers, Inc

  dba Community Medical Centers -Tracy

  • Federally Qualified Health Center (FQHC)
  • Tracy, CA
  • NPI 1609867787
  NPD

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1699193706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 WATERLOO RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054256",
            "telephone_number": "209-940-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 WATERLOO RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054256",
            "telephone_number": "209-940-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIN",
        "first_name": "ANGIE",
        "middle_name": "Y.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "00306046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "00306046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Mahmoud, PHARMD, BCCCP
• Mai T. Vu D.D.S.,Inc.
• Yvonne My Y Thuy Mai, PHARMD
• Tracey Maier, PHARM D
• Main Street Youth & Family Services
• Alex Kangethe Maina, REGISTERED NURSE
• Grace Njoki Maina
• Jennifer Maina
• Daniel Maionchi, MD
• Katrina M Major

• Clinical Social Worker in Stockton, CA
• Providers in Stockton, 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 Dec 13, 2023; 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.