Active NPI
Michelle Ashley Mata
- Social Worker
- Lake Forest, CA
National Provider Identifier
1013340777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW126945
- Practice address
- 22942 El Toro Rd
Lake Forest, CA 92630-4961 - Phone
- (510) 317-1444
- NPI assigned
- Aug 16, 2013
- Sex
- Female
- 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 | ASW126945 | CA | Primary |
Addresses
Primary practice location
22942 El Toro Rd
Lake Forest, CA 92630-4961
Mailing address
22942 El Toro Rd
Lake Forest, CA 92630-4961
Phone (510) 317-1444
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 |
|---|---|---|---|
| ASW126945 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1013340777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22942 EL TORO RD",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926304961",
"telephone_number": "510-317-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22942 EL TORO RD",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926304961",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "MICHELLE",
"middle_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-16",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW126945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.