Individual provider Active NPI

Mannya Rajesh Sharma, LCSW

  • Clinical Social Worker
  • Covina, CA
National Provider Identifier
1063005213
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121039 Issued in CA
Practice address
1085 W Badillo St
Covina, CA 91722-4112
Phone
(626) 332-8138
Fax
(626) 332-0433
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 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 121039 CA Primary

Addresses

Primary practice location

1085 W Badillo St
Covina, CA 91722-4112

Mailing address

5400 Pomona Blvd
Los Angeles, CA 90022-1717
Phone (323) 837-2133

Other practice location 1

2025 N D St
San Bernardino, CA 92405-3913
Phone (909) 475-8793

Other practice location 2

5400 Pomona Blvd
Los Angeles, CA 90022-1717
Phone (323) 837-2400

Other names 1

  • Mannya S. Acosta-Duque Former name

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
I20240402004150 CA Practitioner - Clinical Social Worker 8628416187 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121039CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Mar 22, 2024 Accepting new patients
Nuevo Amanecer Latino Children'S Services CurrentSince Oct 5, 2021 Accepting new patients
Wellmind Online Ca Licensed Clinical Social Worker Prof Corp Clinical CurrentSince Mar 19, 2024 Accepting new patients
Nuevo Amanecer Latino Children'S Services PastSince Feb 1, 2021 Accepting new patients

Locations

1085 W Badillo St
Covina, CA 91722
Phone (626) 332-8138

16501 Ventura Blvd
Encino, CA 91436
Phone (818) 356-8106

888 Prospect St
La Jolla, CA 92037
Phone (619) 804-0609

5400 Pomona Blvd
Los Angeles, CA 90022
Phone (323) 720-9951

2100 Geng Rd
Ste 210
Palo Alto, CA 94303
Phone (650) 383-0279

980 9th St
Sacramento, CA 95814

95 3rd St
San Francisco, CA 94103
Phone (414) 640-9090

99 Almaden Blvd
San Jose, CA 95113
Phone (707) 641-6006

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

2450 Colorado Ave
Santa Monica, CA 90404

3558 Round Barn Blvd
Santa Rosa, CA 95403
Phone (707) 571-3754

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1063005213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221717",
            "telephone_number": "323-837-2133",
            "fax_number": "323-721-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917224112",
            "telephone_number": "626-332-8138",
            "fax_number": "626-332-0433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 N D St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924053913",
            "country_code": "US",
            "telephone_number": "909-475-8793",
            "fax_number": "909-886-4958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5400 Pomona Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900221717",
            "country_code": "US",
            "telephone_number": "323-837-2400",
            "fax_number": "323-721-2437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "MANNYA",
        "middle_name": "RAJESH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANNYA",
            "last_name": "ACOSTA-DUQUE",
            "middle_name": "S.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.