Individual provider Active NPI

Marlene Yesenia Flores-Avila, LCSW

  • Clinical Social Worker
  • Baldwin Park, CA
National Provider Identifier
1174746069
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 22126 Issued in CA
Practice address
1011 Baldwin Park Blvd
Educational Outreach Program - Basement
Baldwin Park, CA 91706-5806
Phone
(626) 851-6365
Fax
(626) 851-5949
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS 22126 CA Primary

Addresses

Primary practice location

1011 Baldwin Park Blvd
Educational Outreach Program - Basement
Baldwin Park, CA 91706-5806

Mailing address

1011 Baldwin Park Blvd
Educational Outreach Program - Basement
Baldwin Park, CA 91706-5806
Phone (626) 851-6365

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

State licenses

LicenseStateTypeSpecialty
LCS 22126CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174746069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BALDWIN PARK BLVD",
            "address_2": "EDUCATIONAL OUTREACH PROGRAM - BASEMENT",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065806",
            "telephone_number": "626-851-6365",
            "fax_number": "626-851-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BALDWIN PARK BLVD",
            "address_2": "EDUCATIONAL OUTREACH PROGRAM - BASEMENT",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065806",
            "telephone_number": "626-851-6365",
            "fax_number": "626-851-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES-AVILA",
        "first_name": "MARLENE",
        "middle_name": "YESENIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.