Active NPI
Janet Medrano Reyes, LCSW, PPSC
- Clinical Social Worker
- Santa Monica, CA
National Provider Identifier
1114294543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW84170
- Practice address
- 1533 Euclid St
Santa Monica, CA 90404 - Phone
- (310) 451-9747
- NPI assigned
- Nov 30, 2011
- 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 | |||
| Clinical Social Worker | 1041C0700X | LCSW84170 | CA | Primary |
Addresses
Primary practice location
1533 Euclid St
Santa Monica, CA 90404
Mailing address
1533 Euclid St
Santa Monica, CA 90404-3306
Phone (310) 451-9747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 11, 2025 through Jul 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW84170 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1114294543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1533 EUCLID ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904043306",
"telephone_number": "310-451-9747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1533 EUCLID ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90404",
"telephone_number": "310-451-9747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDRANO REYES",
"first_name": "JANET",
"name_prefix": "Ms.",
"credential": "LCSW, PPSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-30",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW84170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.