Individual provider Active NPI

Kathleen Joan Easterwood, LCSW

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1750587994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 13296 Issued in CA
Practice address
325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243
Phone
(909) 386-5500
Fax
(909) 386-5570
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS 13296 CA Primary

Addresses

Primary practice location

325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243

Mailing address

325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243
Phone (909) 386-5500

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
LCS 13296CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750587994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN",
            "address_2": "SUITE 312",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083243",
            "telephone_number": "909-386-5500",
            "fax_number": "909-386-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN",
            "address_2": "SUITE 312",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083243",
            "telephone_number": "909-386-5500",
            "fax_number": "909-386-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERWOOD",
        "first_name": "KATHLEEN",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 13296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.