Individual provider Active NPI

Juan Saavedra

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1134555097
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW66607 Issued in CA
Practice address
1200 Wilshire Blvd
Suite 200
Los Angeles, CA 90017-1908
Phone
(213) 481-1347
Fax
(213) 481-7147
NPI assigned
Sep 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X ASW66607 CA Primary

Addresses

Primary practice location

1200 Wilshire Blvd
Suite 200
Los Angeles, CA 90017-1908

Mailing address

1200 Wilshire Blvd
Suite 200
Los Angeles, CA 90017-1908
Phone (213) 481-1347

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
I20260605002353 CA Practitioner - Clinical Social Worker 4789155136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cognitive Care Solutions Group IncGroup PAC ID 5698066124, 42 clinicians

Practice addresses (Care Compare)

32170 Niguel Rd
Laguna Niguel, CA 92677-4264
Phone (877) 295-3747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW66607CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amanecer Community Counseling Service, a Non-Profit Corporation PastSince Jul 1, 2022 Accepting new patients
Amanecer Community Counseling Service, a Non-Profit Corporation PastSince Mar 21, 2021 Accepting new patients

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1134555097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-1347",
            "fax_number": "213-481-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-1347",
            "fax_number": "213-481-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAAVEDRA",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW66607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.