Individual provider Active NPI

Lydia Beth Stanton, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1770676769
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS20525 Issued in CA
Practice address
3435 Camino del Rio S
Ste 123
San Diego, CA 92108-3910
Phone
(619) 980-3396
Fax
(619) 574-8515
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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 LCS20525 CA Primary

Addresses

Primary practice location

3435 Camino del Rio S
Ste 123
San Diego, CA 92108-3910

Mailing address

3435 Camino del Rio S
Ste 123
San Diego, CA 92108-3910
Phone (619) 980-3396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS20525CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1770676769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 CAMINO DEL RIO S",
            "address_2": "STE 123",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083910",
            "telephone_number": "619-980-3396",
            "fax_number": "619-574-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 CAMINO DEL RIO S",
            "address_2": "STE 123",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083910",
            "telephone_number": "619-980-3396",
            "fax_number": "619-574-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "LYDIA",
        "middle_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS20525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.