Individual provider Active NPI

Tomiko Tani Bracken, LCSW

  • Clinical Social Worker
  • Valencia, CA
National Provider Identifier
1922245232
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS23636 Issued in CA
Practice address
28416 Constellation Rd
Valencia, CA 91355-5081
Phone
(661) 713-9989
NPI assigned
Jan 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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 LCS23636 CA Primary

Addresses

Primary practice location

28416 Constellation Rd
Valencia, CA 91355-5081

Mailing address

28626 Ponderosa St
Castaic, CA 91384-4744
Phone (661) 713-9989

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
LCS23636CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1922245232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28626 PONDEROSA ST",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913844744",
            "telephone_number": "661-713-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28416 CONSTELLATION RD",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555081",
            "telephone_number": "661-713-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "TOMIKO",
        "middle_name": "TANI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.