Active NPI
Lisa Kozlowski
- Clinical Social Worker
- Corona, CA
National Provider Identifier
1831438613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 119672
- Practice address
- 2813 S Main St
Corona, CA 92882-5942 - Phone
- (951) 737-2962
- NPI assigned
- Feb 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Clinical Social Worker | 1041C0700X | 119672 | CA | Primary |
Addresses
Primary practice location
2813 S Main St
Corona, CA 92882-5942
Mailing address
1240 E Ontario Ave Ste 102-148
Corona, CA 92881-8671
Phone (714) 315-8101
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
| License | State | Type | Specialty |
|---|---|---|---|
| 119672 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inland Valley Recovery Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- San Bernardino, CA
- NPI 1427464429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1831438613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1240 E ONTARIO AVE STE 102-148",
"city": "CORONA",
"state": "CA",
"postal_code": "928818671",
"telephone_number": "714-315-8101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2813 S MAIN ST",
"city": "CORONA",
"state": "CA",
"postal_code": "928825942",
"telephone_number": "951-737-2962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZLOWSKI",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-13",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "119672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.