Individual provider Active NPI

Denisha Latoya Profit

  • Clinical Social Worker
  • Delano, CA
National Provider Identifier
1104113158
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80561 Issued in CA
Practice address
2737 W Cecil Ave
Delano, CA 93215-1821
Phone
(661) 721-2345
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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 80561 CA Primary

Addresses

Primary practice location

2737 W Cecil Ave
Delano, CA 93215-1821

Mailing address

1825 3Rd St Apt C
Bakersfield, CA 93304-2877

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
I20230605003091 CA Practitioner - Clinical Social Worker 3173980265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Practice addresses (Care Compare)

Palm Springs, CA 92264
Phone (855) 241-7160

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
80561CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters CurrentSince Mar 27, 2022 Accepting new patients
North Kern State Prison PastSince Mar 27, 2022 Accepting new patients

Locations

2737 W Cecil Ave
Delano, CA 93215

Organizations & group practices 3

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1104113158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 3RD ST APT C",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933042877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 W CECIL AVE",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151821",
            "telephone_number": "661-721-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFIT",
        "first_name": "DENISHA",
        "middle_name": "LATOYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delano, CA

Sources for this page

Verify at the official NPI Registry.