Individual provider Active NPI

Kelly Christine Segovia, LCSW

  • Clinical Social Worker
  • Pico Rivera, CA
National Provider Identifier
1760512230
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS19631 Issued in CA
Practice address
4400 Rosemead Blvd
Suite 12
Pico Rivera, CA 90660-1759
Phone
(562) 692-1517
Fax
(562) 699-1378
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 LCS19631 CA Primary

Addresses

Primary practice location

4400 Rosemead Blvd
Suite 12
Pico Rivera, CA 90660-1759

Mailing address

4400 Rosemead Blvd
Suite 12
Pico Rivera, CA 90660-1759
Phone (562) 692-1517

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
LCS19631CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alma Family Services Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1760512230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 ROSEMEAD BLVD",
            "address_2": "SUITE 12",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906601759",
            "telephone_number": "562-692-1517",
            "fax_number": "562-699-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 ROSEMEAD BLVD",
            "address_2": "SUITE 12",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906601759",
            "telephone_number": "562-692-1517",
            "fax_number": "562-699-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGOVIA",
        "first_name": "KELLY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.