Petra Betancourt

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

84544 Issued in CA

Practice address

11565 Laurel Canyon Blvd.
Suite #116
Mission Hills, CA 91430

Phone

(818) 361-5030

Fax

(818) 361-1764

NPI assigned

Jan 9, 2008

Last updated

Dec 3, 2018By the provider in NPPES

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Neighborhood Health Foundation

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1639336803
  Medicare reassignment

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1194900027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 MCLAUGHLIN AVE APT 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665447",
            "telephone_number": "310-869-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 LAUREL CANYON BLVD.",
            "address_2": "SUITE #116",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "91430",
            "telephone_number": "818-361-5030",
            "fax_number": "818-361-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "PETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "84544",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilma Benjamin, M.D.
• Nilda Benmaor, R.D
• Theresa U Bennett, LMFT
• Anamaria Berryman, LCSW
• Magued F Beshay, MD
• Eveleen Bhasin, D.O.
• Deepti Bhatnagar
• Bio-Medical Applications of Mission Hills, Inc. (Fresenius Medical Care of Mission Hills)
• Sepideh Birjani
• Blue Sky Home Health, Inc.

• Clinical Social Worker in Mission Hills, CA
• Providers in Mission Hills, 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 Dec 3, 2018; 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.