Active NPI
Malik Summers
- Clinical Social Worker
- Lynwood, CA
National Provider Identifier
1003629346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 136462
- Practice address
- 11705 Deputy Yamamoto PL
Lynwood, CA 90262-4031 - Phone
- (323) 242-5000
- NPI assigned
- Jan 30, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 136462 | CA | Primary |
Addresses
Primary practice location
11705 Deputy Yamamoto PL
Lynwood, CA 90262-4031
Mailing address
11705 Deputy Yamamoto PL
Lynwood, CA 90262-4031
Phone (323) 242-5000
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 |
|---|---|---|---|
| 136462 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1003629346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11705 DEPUTY YAMAMOTO PL",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902624031",
"telephone_number": "323-242-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11705 DEPUTY YAMAMOTO PL",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902624031",
"telephone_number": "323-242-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "MALIK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-30",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "136462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.