Individual provider Active NPI

Julio Cesar Garibay

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1073921300
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW88708 Issued in CA
Practice address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone
(213) 241-3841
Fax
(213) 241-3305
NPI assigned
Jul 30, 2014
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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 LCSW88708 CA Primary

Addresses

Primary practice location

333 S Beaudry Ave
Los Angeles, CA 90017-1466

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other practice location 1

1605 W Olympic Blvd Ste 1036
Los Angeles, CA 90015-3874
Phone (424) 243-5363

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
I20190715001338 CA Practitioner - Clinical Social Worker 2264767110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Practice addresses (Care Compare)

39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW88708CAMDClinical Social Worker
88708CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of California LLC Clinical CurrentSince May 22, 2019 Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 1

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": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1073921300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 W Olympic Blvd Ste 1036",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153874",
            "country_code": "US",
            "telephone_number": "424-243-5363",
            "fax_number": "213-289-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARIBAY",
        "first_name": "JULIO",
        "middle_name": "CESAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW88708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.