Active NPI
Lourdes Ortega Miranda, LCSW
- Clinical Social Worker
- Gardena, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 81660
- Practice address
- 1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175 - Phone
- (323) 241-6730
- NPI assigned
- Aug 22, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW66105 | CA | |
| Clinical Social Worker | 1041C0700X | 81660 | CA | Primary |
Addresses
Primary practice location
1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175
Mailing address
1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175
Phone (323) 241-6730
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7184 | Other | CA | MEDI-CAL |
| 7667 | Other | CA | MEDI-CAL |
| 7708 | Other | CA | MEDI-CAL |
| 7368 | Other | CA | MEDI-CAL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2311 W El Segundo Blvd
South Bay MHS
Hawthorne, CA 90250-3315
Phone (310) 241-6730
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW66105 | CA | MD | Clinical Social Worker |
| 81660 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| Amanecer Community Counseling Service, a Non-Profit Corporation | Past | Accepting new patients | |
| Amanecer Community Counseling Service, a Non-Profit Corporation | Past | Accepting new patients |
Locations
1045 W Redondo Beach Blvd
Ste 300
Gardena, CA 90247
Phone (310) 352-4170
10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837
2311 W El Segundo Blvd
Hawthorne, CA 90250
Phone (310) 241-6730
510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416
Organizations & group practices 5
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1083633929
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Huntington Park, CA
- NPI 1356636658
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Arcadia, CA
- NPI 1902676075
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1053449900
-
- Community/Behavioral Health Agency
- Lynwood, CA
- NPI 1962882332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1083962096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 W REDONDO BEACH BLVD STE 300",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474175",
"telephone_number": "323-241-6730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 W REDONDO BEACH BLVD STE 300",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474175",
"telephone_number": "323-241-6730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "LOURDES",
"middle_name": "ORTEGA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-22",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW66105",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "81660",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "7184",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "7667",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "7708",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "7368",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.