Individual provider Active NPI

Samuel Hill

  • Clinical Social Worker
  • Costa Mesa, CA
National Provider Identifier
1740177138
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123849 Issued in CA
Practice address
3151 Airway Ave Ste K203
Costa Mesa, CA 92626-4638
Phone
(949) 520-0949
NPI assigned
Jun 19, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 123849 CA Primary

Addresses

Primary practice location

3151 Airway Ave Ste K203
Costa Mesa, CA 92626-4638

Mailing address

1262 S Barrington Ave Apt 102
Los Angeles, CA 90025-1643
Phone (626) 390-6640

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

LicenseStateTypeSpecialty
123849CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1740177138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 S BARRINGTON AVE APT 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251643",
            "telephone_number": "626-390-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE K203",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264638",
            "telephone_number": "949-520-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.