Individual provider Active NPI

Brenda Delacruz

  • Clinical Social Worker
  • Pacoima, CA
National Provider Identifier
1174707335
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114625 Issued in CA
Practice address
13755 Carl St
Pacoima, CA 91331-3719
Phone
(818) 270-0393
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114625 CA Primary
Clinical Social Worker 1041C0700X 149031634 IL

Addresses

Primary practice location

13755 Carl St
Pacoima, CA 91331-3719

Mailing address

13755 Carl St
Pacoima, CA 91331-3719

Other practice location 1

501 Davis St
Evanston, IL 60201-4619
Phone (818) 270-0393

Other identifiers 3

IdentifierTypeStateIssuer
7068MedicaidCA
6758MedicaidCA
7420MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260610002216 IL Practitioner - Clinical Social Worker 4183195175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 E Superior
Suite 306
Chicago, IL 60611

1 E Superior
Suite 306
Chicago, IL 60611-2507

1 E Superior St
Suite 306
Chicago, IL 60611-2595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149031634ILMDClinical Social Worker

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": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1174707335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13755 CARL ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 CARL ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313719",
            "telephone_number": "818-270-0393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Davis St",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602014619",
            "country_code": "US",
            "telephone_number": "818-270-0393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114625",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149031634",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6758",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacoima, CA

Sources for this page

Verify at the official NPI Registry.