Individual provider Active NPI

Vivian Louise Nnana, LCSW

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1730636960
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113908 Issued in CA
Practice address
4361 Latham St Ste 220
Riverside, CA 92501-1767
Phone
(206) 906-5385
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X
Clinical Social Worker 1041C0700X 113908 CA Primary

Addresses

Primary practice location

4361 Latham St Ste 220
Riverside, CA 92501-1767

Mailing address

4361 Latham St Ste 220
Riverside, CA 92501-1767

Other practice location 1

4495 Coppermine St
Riverside, CA 92501-1589
Phone (951) 880-8303

Other identifiers 1

IdentifierTypeStateIssuer
20140602051601MedicaidCA

Other names 1

  • Mrs. Vivian Lousie Nnana Professional name

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
I20241022005537 CA Practitioner - Clinical Social Worker 3870934151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113908CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 13, 2023 Accepting new patients
Community Health Systems, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Indiana University Health Ball Memorial Hospital, Inc. Past Accepting new patients
Victor Community Support Services Inc Past Accepting new patients
Community Health Systems, Inc. Past Accepting new patients

Locations

22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

21801 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

4361 Latham St
Ste 220
Riverside, CA 92501
Phone (206) 906-5385

Interoperability endpoints

  • Direct secure messaging: vivian.nnana.p1@direct.chsica.nextgenshare.com

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1730636960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 LATHAM ST STE 220",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 LATHAM ST STE 220",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011767",
            "telephone_number": "206-906-5385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4495 Coppermine St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925011589",
            "country_code": "US",
            "telephone_number": "951-880-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NNANA",
        "first_name": "VIVIAN",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20140602051601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "NNANA",
            "middle_name": "LOUSIE",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.