Mayra Melgoza

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

125354 Issued in CA

Practice address

840 N Avenue 66
Los Angeles, CA 90042-1508

Phone

(626) 395-7100

NPI assigned

Sep 14, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Victoria Community Counseling Licensed Clinical Social Worker CoGroup PAC ID 4385099720, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Victoria Community Counseling Licensed Clinical Social Worker Co

  • Clinical Social Worker
  • Riverside, CA
  • NPI 1396432951
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1003586835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24115 AMBERLEY DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N AVENUE 66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421508",
            "telephone_number": "626-395-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4187 Flat Rock Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925057124",
            "country_code": "US",
            "telephone_number": "951-476-5642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Highland Springs Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922235771",
            "country_code": "US",
            "telephone_number": "626-395-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELGOZA",
        "first_name": "MAYRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Melgar
• Destiny Crystal Melgar
• Juan Gabriel Melgar, DENTAL-ORAL ASSIST
• Angela Melgarejo
• Itzel Paola Melgoza
• Salvador Junior Melgoza Jr.
• Mariam Melidonian, D.C.
• Raffi Melikian
• Virginia Lise Melin, LMFT
• Melinda D Meshad

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.