Active NPI
Mirna Cervantes, LCSW
- Clinical Social Worker
- Culver City, CA
National Provider Identifier
1184004368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS29531
- Practice address
- 5183 Overland Ave Ste C
Culver City, CA 90230-4990 - Phone
- (310) 936-3308
- NPI assigned
- Jun 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | LCS29531 | CA | Primary |
Addresses
Primary practice location
5183 Overland Ave Ste C
Culver City, CA 90230-4990
Mailing address
PO Box 1122
Culver City, CA 90232-1122
Phone (310) 936-3308
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS29531 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1184004368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1122",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902321122",
"telephone_number": "310-936-3308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5183 OVERLAND AVE STE C",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304990",
"telephone_number": "310-936-3308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERVANTES",
"first_name": "MIRNA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-03",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS29531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.