Active NPI
Melissa Marie Banales, LCSW
- Clinical Social Worker
- Irwindale, CA
National Provider Identifier
1093974735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW76700
- Practice address
- 13001 Ramona Blvd Ste E
Irwindale, CA 91706-3752 - Phone
- (626) 480-8107
- NPI assigned
- Jun 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34712 | CA | |
| Rehabilitation Practitioner | 225400000X | |||
| Clinical Social Worker | 1041C0700X | LCSW76700 | CA | Primary |
Addresses
Primary practice location
13001 Ramona Blvd Ste E
Irwindale, CA 91706-3752
Mailing address
1191 W Grand Ave
Pomona, CA 91766-2747
Phone (909) 762-5034
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW76700 | CA | MD | Clinical Social Worker |
| 34712 | CA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1093974735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1191 W GRAND AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917662747",
"telephone_number": "909-762-5034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13001 RAMONA BLVD STE E",
"city": "IRWINDALE",
"state": "CA",
"postal_code": "917063752",
"telephone_number": "626-480-8107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANALES",
"first_name": "MELISSA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-06",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "34712",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW76700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irwindale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.