Kanita Bourne Licensed Clinical Social Worker Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KANITA BOURNE LICENSED CLINICAL SOCIAL WORKER INC.

Practice address

10601 Civic Center Dr # 100Ad
Rancho Cucamonga, CA 91730-3878

Phone

(909) 520-7949

Fax

(909) 614-8012

NPI assigned

Nov 16, 2020

Organization subpart

No

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

Authorized official

Name

Kanita BourneNPI 1144475013

Title

Owner

Phone

(909) 520-7949

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kanita Danielle Bourne, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1144475013
  NPD Authorized official

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1861095671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 S ARCHIBALD AVE",
            "address_2": "SUITE A #222",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91761",
            "telephone_number": "909-520-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 CIVIC CENTER DR # 100AD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303878",
            "telephone_number": "909-520-7949",
            "fax_number": "909-614-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANITA BOURNE LICENSED CLINICAL SOCIAL WORKER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "KANITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-520-7949"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaman Enterprise Solutions Inc
• Sheldon Kamei
• Min Kang
• Sarah Kang, OTR/L
• Vazira Mohammed Kanga
• Kevin G Kanzelman, PT
• Cristina Marie Kaplan
• Emilie Bree Kapono, LMFT
• Vatche Kaprielian, PHYSICIAN ASSISTANT
• Azatuhi Victoria Karatorosian, RBT

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Nov 16, 2020; 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.