Individual provider Active NPI

Heather Yvonne Daniels, LICSW

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1881164424
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200001653 Issued in DC
Practice address
2074 N Albright Ave
Upland, CA 91784-1202
Phone
(865) 748-2433
NPI assigned
Nov 27, 2018
Last updated
Jan 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 LC200001653 DC Primary

Addresses

Primary practice location

2074 N Albright Ave
Upland, CA 91784-1202

Mailing address

2074 N Albright Ave
Upland, CA 91784-1202
Phone (865) 748-2433

Other identifiers 1

IdentifierTypeStateIssuer
1881164424MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250306001705 DC Practitioner - Clinical Social Worker 9537680525 Reassigns benefits to 1 organization
I20250307003136 CA Practitioner - Clinical Social Worker 9537680525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC200001653DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Feb 7, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Feb 7, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1881164424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 N ALBRIGHT AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841202",
            "telephone_number": "865-748-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 N ALBRIGHT AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841202",
            "telephone_number": "865-748-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "HEATHER",
        "middle_name": "YVONNE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2023-01-27",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881164424",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.