Active NPI
Donna Demerjian
- Clinical Social Worker
- Santa Ana, CA
National Provider Identifier
1770645459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS13748
- Practice address
- 1221 E Dyer Rd
Suite 220
Santa Ana, CA 92705-5600 - Phone
- (714) 491-1011
- Fax
- (714) 617-7639
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY20279 | CA | |
| Clinical Social Worker | 1041C0700X | LCS13748 | CA | Primary |
Addresses
Primary practice location
1221 E Dyer Rd
Suite 220
Santa Ana, CA 92705-5600
Mailing address
1221 E Dyer Rd
Suite 220
Santa Ana, CA 92705-5600
Phone (714) 492-1011
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY20279 | CA | MD | Psychologist |
| LCS13748 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CSP | 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.
-
- Case Management Agency
- Santa Ana, CA
- NPI 1992046601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1770645459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 E DYER RD",
"address_2": "SUITE 220",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927055600",
"telephone_number": "714-492-1011",
"fax_number": "714-617-7639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 E DYER RD",
"address_2": "SUITE 220",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927055600",
"telephone_number": "714-491-1011",
"fax_number": "714-617-7639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMERJIAN",
"first_name": "DONNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY20279",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS13748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.