Unknown Individual – Clinical Social Worker, NPI 1740361757

Unknown Individual is a healthcare provider. based in Avalon, California. specializing in Clinical Social Worker. They hold a License No. LCS23139 (CA). The NPI Number for Unknown Individual is 1740361757

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740361757
Phone
(310) 510-0520
Address
100 FALLS CANYON ROAD
Deactivation Date
14 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9094363034
Graduation Year
2001 (25 years ago)
PAC ID
1951316553
Group Practice PAC ID
7012826878
Professional Enrollment ID
I20060220000136
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 100, Falls Canyon Road, Avalon, Los Angeles County, California, 90704, United States

    AVALON, CA 90704

    Phone: (310) 510-0520

    Fax: (310) 510-2381

    Type: Location

  • Avalon Post Office, 108, East Main Street, Avalon, Ellis County, Texas, 76623, United States

    100 FALLS CANYON RD.

    AVALON, CA 907041665

    Phone: (310) 510-0520

    Fax: (310) 510-2381

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012826878View full group profile
NameSpecialtyState
Family PracticeCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
General SurgeryCA
Clinical Social WorkerMN
Internal Medicine, Family PracticeCA
Nurse PractitionerCA
General SurgeryAZ
O B S T E T R I C S/ G Y N E C O L O G YCA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1740361757 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Avalon, California.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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