Sofia Ahmed

Individual provider Active NPI Clinical Social Worker · Tustin, CA

NPI 1992524151 · NPPES record last updated Oct 5, 2024

Key facts

NPI
1992524151
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
126271 (CA)
Practice address
12205 Glines CT
Tustin, CA 92782-1287
Phone
(801) 634-4470
NPI assigned
Oct 5, 2024
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
126271CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. Single Specialty Past Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X 126271 CA Yes

Addresses

Primary practice location

12205 Glines CT
Tustin, CA 92782-1287

Mailing address

12205 Glines CT
Tustin, CA 92782-1287
Phone (801) 634-4470

Other providers in Tustin, CA

All providers in Tustin, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.