Shade Tree Wellness Services, a Licensed Clinical Social Worker Co

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SHADE TREE WELLNESS SERVICES, A LICENSED CLINICAL SOCIAL WORKER CO

Practice address

1179 Grace LN
S El Monte, CA 91733-6802

Phone

(626) 313-6864

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Lashandra Davis, LCSWNPI 1063757433

Title

President

Phone

(626) 313-6864

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lashandra K Davis, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1063757433
  NPD Authorized official

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1831955590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 S ATLANTIC BLVD # 1099",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917546805",
            "telephone_number": "626-313-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 GRACE LN",
            "city": "S EL MONTE",
            "state": "CA",
            "postal_code": "917336802",
            "telephone_number": "626-313-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADE TREE WELLNESS SERVICES, A LICENSED CLINICAL SOCIAL WORKER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LASHANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-313-6864",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon S Pan
• Lu Pu, MD
• Selena Christine Ramirez, AMFT
• Reliable Transportation Services
• Cheri Sauter, MS
• Siu Wan Wong, M.D.,Inc
• Victoria Soekamto, NURSE PRACTITIONER
• Herbert S Su, DDS
• Tan Van Nguyen MD, Inc.
• Tan Van Nguyen, M.D., Inc

• Clinical Social Worker in S El Monte, CA
• Providers in S El Monte, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.