Individual provider Active NPI

Elizabeth M Landram, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1972268589
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60789 Issued in CA
Practice address
2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone
(858) 279-1223
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 60789 CA Primary

Addresses

Primary practice location

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Mailing address

12250 Crosthwaite Cir
Poway, CA 92064-6882
Phone (858) 748-5044

Other practice location 1

12250 Crosthwaite Cir
Poway, CA 92064-6882
Phone (858) 748-5044 ext. 15

Other identifiers 1

IdentifierTypeStateIssuer
1568659977MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A Poway Adult Day Health Care Center LLC

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
I20260423001834 CA Practitioner - Clinical Social Worker 9032686308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

2300 Boswell Rd
Suite 275
Chula Vista, CA 91914-3557
Phone (858) 279-1223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rana Mansour Advanced Podiatry Institute, a Professional Corporati PastSince Nov 16, 2021 Accepting new patients

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1972268589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 CROSTHWAITE CIR",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920646882",
            "telephone_number": "858-748-5044",
            "fax_number": "858-748-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12250 Crosthwaite Cir",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920646882",
            "country_code": "US",
            "telephone_number": "858-748-5044 x15",
            "fax_number": "858-748-5405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRAM",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568659977",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "Y",
            "affiliationName": "Poway Adult Day Health Care Center LLC",
            "address_1": "12250 Crosthwaite Cir",
            "city": "Poway",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920646882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.