Individual provider Active NPI

Samantha Ann Cvetovac, ASW

  • Clinical Social Worker
  • Arroyo Grande, CA
National Provider Identifier
1902520984
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW123935 Issued in CA
Practice address
1350 E Grand Ave
Arroyo Grande, CA 93420-2422
Phone
(805) 474-2168
Fax
(805) 474-2160
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 ASW123935 CA Primary

Addresses

Primary practice location

1350 E Grand Ave
Arroyo Grande, CA 93420-2422

Mailing address

1350 E Grand Ave
Arroyo Grande, CA 93420-2422

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
ASW123935CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1902520984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E GRAND AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E GRAND AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202422",
            "telephone_number": "805-474-2168",
            "fax_number": "805-474-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CVETOVAC",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW123935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.