Active NPI
Kristen Angela Sasse, ACSW
- Social Worker
- Pomona, CA
National Provider Identifier
1700500311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113465
- Practice address
- 21 Rancho Camino Dr Ste 102
Pomona, CA 91766-7020 - Phone
- (888) 588-8995
- NPI assigned
- Sep 27, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Social Worker | 104100000X | 113465 | CA | Primary |
Addresses
Primary practice location
21 Rancho Camino Dr Ste 102
Pomona, CA 91766-7020
Mailing address
21 Rancho Camino Dr Ste 102
Pomona, CA 91766-7020
Phone (888) 588-8995
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 |
|---|---|---|---|
| 113465 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1700500311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 RANCHO CAMINO DR STE 102",
"city": "POMONA",
"state": "CA",
"postal_code": "917667020",
"telephone_number": "888-588-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 RANCHO CAMINO DR STE 102",
"city": "POMONA",
"state": "CA",
"postal_code": "917667020",
"telephone_number": "888-588-8995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASSE",
"first_name": "KRISTEN",
"middle_name": "ANGELA",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-27",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "113465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.