Individual provider Active NPI

Juan Roberto Valenzuela, ASW

  • Clinical Social Worker
  • Huntington Beach, CA
National Provider Identifier
1013540616
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
90059 Issued in CA
Practice address
17991 Baron Cir Apt 3
Huntington Beach, CA 92647-7504
Phone
(951) 237-8343
NPI assigned
Feb 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 90059 CA Primary

Addresses

Primary practice location

17991 Baron Cir Apt 3
Huntington Beach, CA 92647-7504

Mailing address

17991 Baron Cir Apt 3
Huntington Beach, CA 92647-7504

Other practice location 1

3900 Westerre Pkwy Ste 300
Richmond, VA 23233-1339
Phone (951) 237-8343

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220825000453 CA Practitioner - Clinical Social Worker 4486038403 Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Assessment and Therapy AssociatesGroup PAC ID 2062581481, 21 clinicians

Practice addresses (Care Compare)

1545 Crossways Blvd
Suite 250
Chesapeake, VA 23320-0218
Phone (757) 206-2772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
90059CAMDClinical Social Worker
108781CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Specialists (de), P.a. Clinical Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1013540616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17991 BARON CIR APT 3",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17991 BARON CIR APT 3",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477504",
            "telephone_number": "951-237-8343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Westerre Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232331339",
            "country_code": "US",
            "telephone_number": "951-237-8343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "JUAN",
        "middle_name": "ROBERTO",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-21",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.