Individual provider Active NPI

Melyssa Ann Depaolo, LCSW

  • Clinical Social Worker
  • Westminster, CA
National Provider Identifier
1730429945
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
78241 Issued in CA
Practice address
5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201
Phone
(562) 431-8822
NPI assigned
Feb 25, 2013
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 78241 CA Primary

Addresses

Primary practice location

5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201

Mailing address

5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201
Phone (562) 431-8822

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
I20240725004297 CA Practitioner - Clinical Social Worker 6800332875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

5455 Garden Grove Blvd
Suite 200
Westminster, CA 92683-8201
Phone (562) 431-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78241CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Jun 12, 2024 Accepting new patients

Locations

4040 Barranca Pkwy
Ste 260
Irvine, CA 92604

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

5455 Garden Grove Blvd
Ste 200
Westminster, CA 92683
Phone (206) 906-5385

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.melyssadepaolo@148377.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1730429945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 GARDEN GROVE BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838201",
            "telephone_number": "562-431-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 GARDEN GROVE BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838201",
            "telephone_number": "562-431-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAOLO",
        "first_name": "MELYSSA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.