Individual provider Active NPI

Elaine Kindle, PH.D., LCSW

  • Clinical Social Worker
  • Hacienda HTS, CA
National Provider Identifier
1760413710
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LL9096 Issued in 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
Last updated
Dec 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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 LL9096 CA Primary

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

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
I20120620000315 CA Practitioner - Clinical Social Worker 5395909584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LL9096CAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1760413710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S HACIENDA BLVD",
            "address_2": "SUITE 103-C",
            "city": "HACIENDA HTS",
            "state": "CA",
            "postal_code": "917454600",
            "telephone_number": "626-330-7990",
            "fax_number": "626-855-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S HACIENDA BLVD",
            "address_2": "SUITE 103-C",
            "city": "HACIENDA HTS",
            "state": "CA",
            "postal_code": "917454600",
            "telephone_number": "626-330-7990",
            "fax_number": "626-855-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDLE",
        "first_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LL9096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda HTS, CA

Sources for this page

Verify at the official NPI Registry.