Individual provider Active NPI

Lizeth Lopez Zamora

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1023563848
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW71936 Issued in CA
Practice address
1200 Wilshire Blvd
Suite 210
Los Angeles, CA 90017-1908
Phone
(213) 481-7464
Fax
(213) 481-7147
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW71936 CA Primary

Addresses

Primary practice location

1200 Wilshire Blvd
Suite 210
Los Angeles, CA 90017-1908

Mailing address

1200 Wilshire Blvd
Suite 210
Los Angeles, CA 90017-1908
Phone (213) 481-7464

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
I20210826003103 CA Practitioner - Clinical Social Worker 9537564661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gracelight Community HealthGroup PAC ID 3072619618, 24 clinicians

Practice addresses (Care Compare)

150 N Reno St
Los Angeles, CA 90026-4656
Phone (213) 380-7298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW71936CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gracelight Community Health CurrentSince Aug 16, 2021 Accepting new patients
Gracelight Community Health CurrentSince Aug 16, 2021 Accepting new patients
Amanecer Community Counseling Service, a Non-Profit Corporation PastSince Sep 1, 2022 Accepting new patients
Union Ave Elementary School Past Accepting new patients

Locations

303 Loma Dr
Los Angeles, CA 90017
Phone (213) 858-5126

150 N Reno St
Los Angeles, CA 90026
Phone (213) 380-7298

950 S Grand Ave
Fl 2
Los Angeles, CA 90015

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1023563848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-7464",
            "fax_number": "213-481-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-7464",
            "fax_number": "213-481-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ ZAMORA",
        "first_name": "LIZETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW71936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.