Kelly Fierro Miyakawa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

88099 Issued in CA

Practice address

30877 Bloomfest St
Murrieta, CA 92563

Phone

(909) 720-3591

NPI assigned

Jul 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1174907117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28039 SCOTT ROAD",
            "address_2": "STE D #283",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631181",
            "telephone_number": "909-720-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30877 BLOOMFEST ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92563",
            "telephone_number": "909-720-3591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 W Town and Country Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684712",
            "country_code": "US",
            "telephone_number": "714-547-6494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIYAKAWA",
        "first_name": "KELLY",
        "middle_name": "FIERRO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-18",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna M Mitchell
• Danyelle Mitchell, LVN
• Robin Mitchell
• Jeffrey Allen Mitschang, LMFT
• David Michael Mitzner, D.O.
• MLG Investment Group
• Mobility R US LLC
• Madison Mock
• Modi and Shah D.D.S. Inc.,
• Aaron Kevin Moesser, OTR/L

• Clinical Social Worker in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.

Verify at the official NPI Registry.