Individual provider Active NPI

Dana Wogahn

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1740803600
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94448 Issued in CA
Practice address
1214 Eddington St
Upland, CA 91786-3440
Phone
(909) 931-1137
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 94448 CA Primary

Addresses

Primary practice location

1214 Eddington St
Upland, CA 91786-3440

Mailing address

1214 Eddington St
Upland, CA 91786-3440
Phone (909) 931-1137

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
I20250418000490 CA Practitioner - Clinical Social Worker 4981129327 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
94448CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fields Comp. Youth Services Inc. CurrentSince May 31, 2020 Accepting new patients
Personalized Treatment & Intervention Services CurrentSince Mar 1, 2025 Accepting new patients
Serene Pathways Family Counseling Inc CurrentSince Mar 1, 2025 Accepting new patients
Fields Comp. Youth Services, Inc. PastSince May 31, 2020 Accepting new patients

Locations

11800 Central Ave
Ste 225
Chino, CA 91710
Phone (909) 576-3889

201 Spear St
Ste 1100
San Francisco, CA 94105
Phone (415) 651-4333

Organizations & group practices 4

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1740803600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 EDDINGTON ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863440",
            "telephone_number": "909-931-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 EDDINGTON ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863440",
            "telephone_number": "909-931-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGAHN",
        "first_name": "DANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.