Theadora Zavala Ricker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120500 Issued in CA

Practice address

453 S Spring St Ste 400
Los Angeles, CA 90013-2074

Phone

(323) 391-4711

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 21, 2024 through Feb 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• De Los Dos: a Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1104758762
  NPD Authorized official

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1053894113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 S SPRING ST STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 S SPRING ST STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132074",
            "telephone_number": "323-391-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKER",
        "first_name": "THEADORA",
        "middle_name": "ZAVALA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "120500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Marie Richter, M.D.
• Leanne Ashley Richter
• Stefan Eisen Richter, M.D.
• Rick Deaton, Psy.D., a Prof. Psych. Corp.
• Charite Nicolette Ricker, MS,GCG
• Amber S Rickert
• Laura Rickert, DPT
• Emily Julia Ricketts, PHD
• Herman H Ricketts
• Sariah Ricketts

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.