Individual provider Active NPI

Aimee Denise Vicente

  • Clinical Social Worker
  • Santa Fe Springs, CA
National Provider Identifier
1104226257
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW94228 Issued in CA
Practice address
11731 Telegraph Rd
Santa Fe Springs, CA 90670-3675
Phone
(323) 427-8444
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW71877 CA
Clinical Social Worker 1041C0700X LCSW94228 CA Primary

Addresses

Primary practice location

11731 Telegraph Rd
Santa Fe Springs, CA 90670-3675

Mailing address

11731 Telegraph Rd Ste G
Santa Fe Springs, CA 90670-6819

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
I20210929002341 CA Practitioner - Clinical Social Worker 3072935758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

11741 Telegraph Rd
Suite G
Santa Fe Springs, CA 90670-3687
Phone (562) 942-8256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW71877CAMDMental Health Counselor
LCSW94228CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients
Pacific Clinics Current Accepting new patients
Pacific Clinics Past Accepting new patients
Pacific Clinics Past Accepting new patients

Locations

800 S Santa Anita Ave
Arcadia, CA 91006
Phone (626) 254-5043

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

11721 Telegraph Rd
Ste A
Santa Fe Springs, CA 90670
Phone (562) 949-8355

11741 Telegraph Rd
Ste G
Santa Fe Springs, CA 90670
Phone (562) 303-3815

11731 Telegraph Rd
Ste G
Santa Fe Springs, CA 90670
Phone (562) 907-7429

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.

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1104226257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703675",
            "telephone_number": "323-427-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "AIMEE",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW71877",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW94228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.