Individual provider Active NPI

Kahina Cathleen Kaci, LCSW

  • Clinical Social Worker
  • Orange, CA
National Provider Identifier
1720538283
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60749 Issued in CA
Practice address
4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504
Phone
(714) 972-8002
NPI assigned
Oct 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 60749 CA Primary

Addresses

Primary practice location

4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504

Mailing address

663 S Casita St
Anaheim, CA 92805-4747
Phone (714) 400-5568

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
I20210716000263 CA Practitioner - Clinical Social Worker 7416359211 Reassigns benefits to 3 organizations
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60749CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Medical Group, Inc. CurrentSince Oct 1, 2021 Accepting new patients
County of Orange CurrentSince Aug 16, 2025 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Aug 16, 2025 Accepting new patients

Locations

2035 E Ball Rd
Ste 200
Anaheim, CA 92806
Phone (714) 517-6300

1901 Newport Blvd
Ste 280
Costa Mesa, CA 92627
Phone (281) 210-6703

7677 Center Ave
Ste 405
Huntington Beach, CA 92647
Phone (714) 369-8037

18401 Von Karman Ave
Ste 500
Irvine, CA 92612
Phone (305) 343-5995

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

4000 W Metropolitan Dr
Ste 120
Orange, CA 92868
Phone (714) 972-3716

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 5

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": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1720538283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 S CASITA ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054747",
            "telephone_number": "714-400-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 120",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-972-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACI",
        "first_name": "KAHINA",
        "middle_name": "CATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-08",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.