Individual provider Active NPI

Peter Wang Vang

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1790200905
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW89724 Issued in CA
Practice address
6615 Valley Hi Dr
Sacramento, CA 95823-7076
Phone
(916) 450-2650
NPI assigned
Aug 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW89724 CA
Clinical Social Worker 1041C0700X ASW89724 CA Primary

Addresses

Primary practice location

6615 Valley Hi Dr
Sacramento, CA 95823-7076

Mailing address

6615 Valley Hi Dr
Sacramento, CA 95823-7076
Phone (169) 383-6783

Other practice location 1

9837 Folsom Blvd Ste F
Sacramento, CA 95827-1356
Phone (916) 450-2600

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

LicenseStateTypeSpecialty
ASW89724CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1790200905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 VALLEY HI DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958237076",
            "telephone_number": "169-383-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 VALLEY HI DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958237076",
            "telephone_number": "916-450-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9837 Folsom Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958271356",
            "country_code": "US",
            "telephone_number": "916-450-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANG",
        "first_name": "PETER",
        "middle_name": "WANG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW89724",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW89724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.