Active NPI
Olga Moreno
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1164658365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28933
- Practice address
- 830 Freeman Ave
Long Beach, CA 90804-4913 - Phone
- (909) 773-2076
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 28933 | CA | Primary |
Addresses
Primary practice location
830 Freeman Ave
Long Beach, CA 90804-4913
Mailing address
830 Freeman Ave
Long Beach, CA 90804-4913
Phone (909) 773-2076
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240517000619 | CA | Practitioner - Clinical Social Worker | 9638510902 | Practice locations: Los Angeles, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1164658365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 FREEMAN AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908044913",
"telephone_number": "909-773-2076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 FREEMAN AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908044913",
"telephone_number": "909-773-2076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "OLGA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.