Active NPI
Ian Yuan-Jian Bohannon, LCSW
- Social Worker
- Los Angeles, CA
National Provider Identifier
1992084503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCSW75211
- Practice address
- 11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003 - Phone
- (310) 482-3267
- NPI assigned
- Aug 12, 2011
- Sex
- Male
- Sole proprietor
- No
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 | LCSW75211 | CA | Primary |
Addresses
Primary practice location
11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003
Mailing address
11303 W Washington Blvd
#200
Los Angeles, CA 90066-6003
Phone (310) 482-3267
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 |
|---|---|---|---|
| LCSW75211 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1992084503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11303 W WASHINGTON BLVD",
"address_2": "#200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900666003",
"telephone_number": "310-482-3267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11303 W WASHINGTON BLVD",
"address_2": "#200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900666003",
"telephone_number": "310-482-3267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHANNON",
"first_name": "IAN",
"middle_name": "YUAN-JIAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-12",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW75211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.