Individual provider Active NPI

Andrea Lynn Kaloustian, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1881162246
Registry record updated Nov 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
82531 Issued in CA
Practice address
5901 E 7TH St
Long Beach, CA 90822-5201
Phone
(562) 826-8000
NPI assigned
Nov 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 40577 TX
Clinical Social Worker 1041C0700X 6801071450 MI
Clinical Social Worker 1041C0700X 82531 CA Primary

Addresses

Primary practice location

5901 E 7TH St
Long Beach, CA 90822-5201

Mailing address

2031 Vallejo Dr
Tustin, CA 92782-8619
Phone (949) 705-6485

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
6801071450MIMDClinical Social Worker
40577TXMDClinical Social Worker
82531CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1541289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541289600000",
    "number": "1881162246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 VALLEJO DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927828619",
            "telephone_number": "949-705-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908225201",
            "telephone_number": "562-826-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOUSTIAN",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-04",
        "last_updated": "2018-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40577",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801071450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2018; 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.