Individual provider Active NPI

Jennifer Kristine Luna-Nguyen, LCSW

  • Clinical Social Worker
  • Monrovia, CA
National Provider Identifier
1134767940
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
90761 Issued in CA
Practice address
1333 S Mayflower Ave Ste 360
Monrovia, CA 91016-5280
Phone
(626) 701-4249
Fax
(626) 737-6034
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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 90761 CA Primary

Addresses

Primary practice location

1333 S Mayflower Ave Ste 360
Monrovia, CA 91016-5280

Mailing address

41 E Foothill Blvd Ste 102
Arcadia, CA 91006-2361
Phone (626) 701-4249

Other identifiers 1

IdentifierTypeStateIssuer
90761OtherCALICENSED CLINICAL SOCIAL WORKER

Other names 1

  • Jennifer Kristine Luna Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.soultenders.com

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
I20210528001526 CA Practitioner - Clinical Social Worker 7012316763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90761CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Feb 20, 2021 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

Organizations & group practices 1

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1134767940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E FOOTHILL BLVD STE 102",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062361",
            "telephone_number": "626-701-4249",
            "fax_number": "626-737-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE STE 360",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165280",
            "telephone_number": "626-701-4249",
            "fax_number": "626-737-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA-NGUYEN",
        "first_name": "JENNIFER",
        "middle_name": "KRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "90761",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.soultenders.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1333 S Mayflower Ave Ste 360",
            "city": "Monrovia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910165280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LUNA",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monrovia, CA

Sources for this page

Verify at the official NPI Registry.