Individual provider Active NPI

Shannon O'Brien, LCSW

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1962088062
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
89763 Issued in CA
Practice address
626 W Lancaster Blvd Unit 128
Lancaster, CA 93534-3108
Phone
(661) 434-5997
Fax
(877) 483-9786
NPI assigned
Mar 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904014443 VA
Clinical Social Worker 1041C0700X 89763 CA Primary
Clinical Social Worker 1041C0700X 102476 NY
Clinical Social Worker 1041C0700X 44SC06383300 NJ

Addresses

Primary practice location

626 W Lancaster Blvd Unit 128
Lancaster, CA 93534-3108

Mailing address

626 W Lancaster Blvd Unit 128
Lancaster, CA 93534-3108
Phone (661) 434-5997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000824 CA Practitioner - Clinical Social Worker 7416305057 Reassigns benefits to 1 organization
Practice locations: Lancaster, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

626 W Lancaster Blvd
Unit 128
Lancaster, CA 93534-3108
Phone (661) 434-5997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89763CAMDClinical Social Worker
44SC06383300NJMDClinical Social Worker
102476NYMDClinical Social Worker
0904014443VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Interoperability endpoints

  • Direct secure messaging: shannonobrien@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1962088062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W LANCASTER BLVD UNIT 128",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343108",
            "telephone_number": "661-434-5997",
            "fax_number": "877-483-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W LANCASTER BLVD UNIT 128",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343108",
            "telephone_number": "661-434-5997",
            "fax_number": "877-483-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014443",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89763",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "102476",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06383300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.