Individual provider Active NPI

Helen Joyce Van Dam, LCSW

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1821278045
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS10127 Issued in CA
Practice address
1538 Howard Access Rd Ste B
Upland, CA 91786-2581
Phone
(909) 635-8077
NPI assigned
Nov 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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 LCS10127 CA Primary

Addresses

Primary practice location

1538 Howard Access Rd Ste B
Upland, CA 91786-2581

Mailing address

3401 Cutting Horse Rd
Norco, CA 92860-5108
Phone (951) 582-0382

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

State licenses

LicenseStateTypeSpecialty
10127CAMDPsychologist
LCS10127CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1821278045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CUTTING HORSE RD",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928605108",
            "telephone_number": "951-582-0382",
            "fax_number": "951-582-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 HOWARD ACCESS RD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862581",
            "telephone_number": "909-635-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DAM",
        "first_name": "HELEN",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS10127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.