Individual provider Active NPI

Carlos Beltran

  • Clinical Social Worker
  • Inglewood, CA
National Provider Identifier
1144773904
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108574 Issued in CA
Practice address
323 N Prairie Ave
Inglewood, CA 90301
Phone
(310) 846-2100
Fax
(310) 846-2139
NPI assigned
Jul 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 108574 CA Primary
Mental Health Counselor 101YM0800X 77866 CA
Social Worker 104100000X 77866 CA
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

323 N Prairie Ave
Inglewood, CA 90301

Mailing address

1891 Effie St
Los Angeles, CA 90026-1711
Phone (323) 644-2000

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
I20241217000328 CA Practitioner - Clinical Social Worker 3870020779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77866CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Nov 22, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1144773904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 EFFIE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261711",
            "telephone_number": "323-644-2000",
            "fax_number": "310-398-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "90301",
            "telephone_number": "310-846-2100",
            "fax_number": "310-846-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108574",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "77866",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "77866",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.