Jorge Canseco, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8592 Issued in CA

Practice address

2677 Zoe Ave Ste 120
Huntington Park, CA 90255-6995

Phone

(323) 589-1902

Fax

(323) 589-1805

NPI assigned

Apr 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1114489804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 ZOE AVE STE 120",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556995",
            "telephone_number": "323-589-1902",
            "fax_number": "323-589-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 ZOE AVE STE 120",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556995",
            "telephone_number": "323-589-1902",
            "fax_number": "323-589-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANSECO",
        "first_name": "JORGE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "8592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES - LCSW",
            "identifier": "8592",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@cdf-centro.com",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2677 Zoe Ave Ste 120",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902556995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria R. Campos
• Mayra Campos, RN, FNP-C
• Monica Campos
• Armando Canlas
• Andrea Elizabeth Canseco-de Leon, LMFT
• Josephine Kristy Capili, PA-C
• Jonina Capino
• Felipe Rubio Capiral Jr., OTR, LMFT
• Tonia Ann Capobianco
• Daniel Carabantes

• Clinical Social Worker in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.