Individual provider Active NPI

Connie Nguyen, MSW

  • Clinical Social Worker
  • Orange, CA
National Provider Identifier
1962634071
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
69939 Issued in CA
Practice address
4000 Metropolitan Dr. Suite 402
Orange, CA 92868-3503
Phone
(714) 468-8258
NPI assigned
Aug 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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 69939 CA Primary

Addresses

Primary practice location

4000 Metropolitan Dr. Suite 402
Orange, CA 92868-3503

Mailing address

3611 S Harbor Blvd
Suite 100
Santa Ana, CA 92704-6928
Phone (714) 966-8615

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
I20230109001084 CA Practitioner - Clinical Social Worker 0749650711 Practice locations: Brea, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince Jun 14, 2020 Accepting new patients
South Coast Children'S Society, Inc Past Accepting new patients

Locations

4000 W Metropolitan Dr
Ste 402
Orange, CA 92868
Phone (714) 954-2900

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": "1250985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1962634071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 S HARBOR BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046928",
            "telephone_number": "714-966-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 METROPOLITAN DR. SUITE 402",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683503",
            "telephone_number": "714-468-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CONNIE",
        "name_prefix": "Miss",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-23",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "69939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.