Elaine Kindle, PH.D., LCSW

Individual provider Active NPI Clinical Social Worker · Hacienda HTS, CA

NPI 1760413710 · NPPES record last updated Dec 29, 2011

Key facts

NPI
1760413710
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LL9096 (CA)
Practice address
2211 S Hacienda Blvd
Suite 103-C
Hacienda HTS, CA 91745-4600
Phone
(626) 330-7990
Fax
(626) 855-5476
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2211 S Hacienda Blvd
Suite 103C
Hacienda Heights, CA 91745-4642
Phone (626) 330-7990

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120620000315 CA Practitioner - Clinical Social Worker 5395909584 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LL9096CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LL9096 CA Yes

Addresses

Primary practice location

2211 S Hacienda Blvd
Suite 103-C
Hacienda HTS, CA 91745-4600

Mailing address

2211 S Hacienda Blvd
Suite 103-C
Hacienda HTS, CA 91745-4600
Phone (626) 330-7990

Other identifiers

IdentifierTypeStateIssuer
SW9096MedicaidCA

Other providers in Hacienda HTS, CA

All providers in Hacienda HTS, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.