Individual provider Active NPI

Michael Louis Owen, LCSW

  • Clinical Social Worker
  • Antioch, CA
National Provider Identifier
1912914342
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS8784 Issued in CA
Practice address
3700 Delta Fair Blvd
Suite 202
Antioch, CA 94509-4019
Phone
(925) 756-8097
Fax
(925) 706-0213
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS8784 CA Primary

Addresses

Primary practice location

3700 Delta Fair Blvd
Suite 202
Antioch, CA 94509-4019

Mailing address

3700 Delta Fair Blvd
Suite 202
Antioch, CA 94509-4019
Phone (925) 756-8097

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS8784CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912914342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 DELTA FAIR BLVD",
            "address_2": "SUITE 202",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094019",
            "telephone_number": "925-756-8097",
            "fax_number": "925-706-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 DELTA FAIR BLVD",
            "address_2": "SUITE 202",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094019",
            "telephone_number": "925-756-8097",
            "fax_number": "925-706-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS8784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.