Individual provider Active NPI

Elizabeth Serrano

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1053830232
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW101321 Issued in CA
Practice address
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone
(213) 381-2931
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW79313 CA
Clinical Social Worker 1041C0700X LCSW101321 CA Primary

Addresses

Primary practice location

155 N Occidental Blvd
Los Angeles, CA 90026-4641

Mailing address

155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW79313CAMDMental Health Counselor
LCSW101321CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of California, P.C. Clinical CurrentSince Aug 29, 2024 Accepting new patients
Optum Behavioral Care of California, P.C. CurrentSince Aug 29, 2024 Accepting new patients
Gunn Behavioral Care of California, PC PastSince Jan 8, 2019 Accepting new patients

Locations

2555 E Colorado Blvd
Ste 101
Pasadena, CA 91107
Phone (909) 898-4055

2555 E Colorado Blvd
Pasadena, CA 91107
Phone (909) 989-4055

8300 Utica Ave
Ste 245
Rancho Cucamonga, CA 91730
Phone (909) 989-4055

Interoperability endpoints

  • Direct secure messaging: elizabeth.serrano.1@28621.direct.athenahealth.com

Organizations & group practices 3

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1053830232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N OCCIDENTAL BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264641",
            "telephone_number": "213-381-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N OCCIDENTAL BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264641",
            "telephone_number": "213-381-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW79313",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW101321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.