Individual provider Active NPI

Kristen Marie Traub

  • Clinical Social Worker
  • Hanford, CA
National Provider Identifier
1750507877
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS27139 Issued in CA
Practice address
1393 Bailey Drive
Hanford, CA 93230-5922
Phone
(559) 582-4481
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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 ASW16456 CA
Clinical Social Worker 1041C0700X LCS27139 CA Primary

Addresses

Primary practice location

1393 Bailey Drive
Hanford, CA 93230-5922

Mailing address

1393 Bailey St
Hanford, CA 93230-5922
Phone (559) 582-4481

Other identifiers 1

IdentifierTypeStateIssuer
160101904300MedicaidCA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW16456CAMDClinical Social Worker
LCS27139CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1750507877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1393 BAILEY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305922",
            "telephone_number": "559-582-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1393 BAILEY DRIVE",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305922",
            "telephone_number": "559-582-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUB",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW16456",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS27139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160101904300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.