Individual provider Active NPI

Jenny Lopez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1063812279
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW95091 Issued in CA
Practice address
3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1405
Phone
(213) 235-2500
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 LCSW95091 CA Primary

Addresses

Primary practice location

3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1405

Mailing address

3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108
Phone (213) 235-2500

Other practice location 1

1339 20th St
Santa Monica, CA 90404-2033
Phone (310) 829-8921

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jenny.lopez@providence.org Direct

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
I20230912002082 CA Practitioner - Clinical Social Worker 1456715200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Korean Health Education Information and Research Center CurrentSince Jul 30, 2023 Accepting new patients
Korean Health, Education, Information and Research Center CurrentSince Jul 30, 2023 Accepting new patients

Locations

3255 Wilshire Blvd
Ste 120
Los Angeles, CA 90010
Phone (213) 235-1212

3727 W 6th St
Ste 200
Los Angeles, CA 90020
Phone (213) 235-2500

3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500

Organizations & group practices 2

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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1063812279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 W 6TH ST STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205108",
            "telephone_number": "213-235-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101405",
            "telephone_number": "213-235-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1339 20th St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042033",
            "country_code": "US",
            "telephone_number": "310-829-8921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JENNY",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW95091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jenny.lopez@providence.org",
            "affiliation": "N",
            "endpointDescription": "Professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1339 20th St",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.