Individual provider Active NPI

Victoria Marie Lagrandeur Contreras

  • Clinical Social Worker
  • Anaheim, CA
National Provider Identifier
1790544013
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116436 Issued in CA
Practice address
1360 S Anaheim Blvd Ste 101
Anaheim, CA 92805-6258
Phone
(714) 948-7641
NPI assigned
Mar 18, 2024
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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 116436 CA Primary

Addresses

Primary practice location

1360 S Anaheim Blvd Ste 101
Anaheim, CA 92805-6258

Mailing address

1360 S Anaheim Blvd Ste 101
Anaheim, CA 92805-6258

Other practice location 1

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 233-0425

Other practice location 2

12021 Wilmington Ave Bldg 182nd
Los Angeles, CA 90059-3019
Phone (424) 454-5000

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
116436CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1790544013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056258",
            "telephone_number": "714-948-7641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900115622",
            "country_code": "US",
            "telephone_number": "323-233-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12021 Wilmington Ave Bldg 182nd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900593019",
            "country_code": "US",
            "telephone_number": "424-454-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "VICTORIA",
        "middle_name": "MARIE LAGRANDEUR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "116436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.