Active NPI
Julian Reyes
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1063727105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW69400
- Practice address
- 236 E 58TH St
Los Angeles, CA 90011-5316 - Phone
- (323) 389-7008
- NPI assigned
- Aug 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW32706 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW69400 | CA | Primary |
Addresses
Primary practice location
236 E 58TH St
Los Angeles, CA 90011-5316
Mailing address
550 S Vermont Ave FL 9
Los Angeles, CA 90020-1912
Phone (323) 389-7008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW32706 | CA | MD | Mental Health Counselor |
| LCSW69400 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1063727105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE FL 9",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "323-389-7008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 E 58TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115316",
"telephone_number": "323-389-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "JULIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-12",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW32706",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW69400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.