Melinda Acosta Black, LCSW
Individual provider Active NPI Clinical Social Worker · Santa Ana, CA
NPI 1962056820 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1962056820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 88773 (CA)
- Practice address
- 1526 Brookhollow Drive
Santa Ana, CA 92705 - Phone
- (714) 545-3390
- NPI assigned
- Jul 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88773 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 88773 | CA | Yes |
Addresses
Primary practice location
1526 Brookhollow Drive
Santa Ana, CA 92705
Mailing address
6070 E Camino Correr
Anaheim, CA 92807-3213
Phone (714) 366-3419
Other providers in Santa Ana, CA
- Maria O Aceves
- Maria Acevez
- Achievement Wellness and Acupuncture Inc
- Briana Achmad
- Acoba Chiropractic Group, Apc
- Alisa Marie Acosta
- Andrea Acosta
- Ariana Acosta
- Coral Acosta
- Liliana Acosta
All providers in Santa Ana, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.