Individual provider Active NPI

Diana Aguayo, LCSW

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1073070447
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW86906 Issued in CA
Practice address
1555 S Garey Ave
Pomona, CA 91766-5222
Phone
(909) 620-8088
NPI assigned
Feb 21, 2019
Last updated
Feb 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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 LCSW86906 CA Primary

Addresses

Primary practice location

1555 S Garey Ave
Pomona, CA 91766-5222

Mailing address

10488 Brookmead Dr
Moreno Valley, CA 92557-2616
Phone (951) 567-9035

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
LCSW86906CAMDClinical Social Worker
86906CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Community Health Center, Inc. CurrentSince Jun 25, 2021 Accepting new patients
East Valley Community Health Center, Inc. CurrentSince Jun 25, 2021 Accepting new patients

Locations

1555 S Garey Ave
Pomona, CA 91766
Phone (909) 620-8088

420 S Glendora Ave
West Covina, CA 91790
Phone (626) 919-5724

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1073070447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10488 BROOKMEAD DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925572616",
            "telephone_number": "951-567-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665222",
            "telephone_number": "909-620-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUAYO",
        "first_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW86906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.