Individual provider Active NPI

Rosa Madrigal-Guzman, LCSW

  • Clinical Social Worker
  • Santa Cruz, CA
National Provider Identifier
1154528149
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 26985 Issued in CA
Practice address
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone
(831) 454-4170
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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 LCSW 26985 CA Primary

Addresses

Primary practice location

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Mailing address

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4170

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ92069ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP#
LCSW 26985OtherCAPROFESSIONAL LICENSE
ZZZ91892ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP#

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
I20110816000104 CA Practitioner - Clinical Social Worker 0446429062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 26985CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz CurrentSince Dec 15, 2016 Accepting new patients
Puentes Al Sur Past Accepting new patients

Locations

1400 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4900

1080 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4100

1430 Freedom Blvd
Ste D
Watsonville, CA 95076
Phone (831) 763-8400

1430 Freedom Blvd
Watsonville, CA 95076
Phone (831) 763-8200

Organizations & group practices 2

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1154528149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRIGAL-GUZMAN",
        "first_name": "ROSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 26985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "LCSW 26985",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.