Active NPI
Jose D De Leon
- Community Health Worker
- Los Angeles, CA
National Provider Identifier
1154079473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3881 S Western Ave
Los Angeles, CA 90062-1105 - Phone
- (626) 632-1223
- NPI assigned
- Mar 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
3881 S Western Ave
Los Angeles, CA 90062-1105
Mailing address
3881 S Western Ave
Los Angeles, CA 90062-1105
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | connect |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1154079473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3881 S WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3881 S WESTERN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900621105",
"telephone_number": "626-632-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "JOSE",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-15",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "connect",
"affiliation": "N",
"address_1": "3881 S Western Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900621105",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.