Active NPI
Julie Koo, ASW
- Social Worker
- Lake Elsinore, CA
National Provider Identifier
1982937884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24887
- Practice address
- 31681 Riverside Dr
Suite L
Lake Elsinore, CA 92530-7815 - Phone
- (951) 674-9243
- NPI assigned
- Sep 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 24887 | CA | Primary |
Addresses
Primary practice location
31681 Riverside Dr
Suite L
Lake Elsinore, CA 92530-7815
Mailing address
31681 Riverside Dr
Suite L
Lake Elsinore, CA 92530-7815
Phone (951) 674-9243
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24887 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292803200000",
"number": "1982937884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31681 RIVERSIDE DR",
"address_2": "SUITE L",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925307815",
"telephone_number": "951-674-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31681 RIVERSIDE DR",
"address_2": "SUITE L",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925307815",
"telephone_number": "951-674-9243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOO",
"first_name": "JULIE",
"credential": "ASW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-09",
"last_updated": "2010-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "24887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.