Individual provider Active NPI

Angelique L Hood, PH.D

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1780603415
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS16750 Issued in CA
Practice address
1650 Hotel Cir N
Ste 203
San Diego, CA 92108-2818
Phone
(619) 297-4499
Fax
(619) 297-4479
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 LCS16750 CA Primary

Addresses

Primary practice location

1650 Hotel Cir N
Ste 203
San Diego, CA 92108-2818

Mailing address

1650 Hotel Cir N
Ste 203
San Diego, CA 92108-2818
Phone (619) 297-4499

Other identifiers 1

IdentifierTypeStateIssuer
5920530MedicaidCA

Other names 1

  • Dr. Cornelia Lewis Other name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCS16750CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1780603415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HOTEL CIR N",
            "address_2": "STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082818",
            "telephone_number": "619-297-4499",
            "fax_number": "619-297-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HOTEL CIR N",
            "address_2": "STE 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082818",
            "telephone_number": "619-297-4499",
            "fax_number": "619-297-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOD",
        "first_name": "ANGELIQUE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORNELIA",
            "last_name": "LEWIS",
            "prefix": "DR.",
            "credential": "PH.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.