Active NPI
Jose Chavez
- Clinical Social Worker
- North Hollywood, CA
National Provider Identifier
1205485125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113391
- Practice address
- 6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606-1576 - Phone
- (818) 755-8786
- NPI assigned
- Sep 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Peer Specialist | 175T00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 113391 | CA | Primary |
Addresses
Primary practice location
6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606-1576
Mailing address
6736 Laurel Canyon Blvd Ste 200
North Hollywood, CA 91606-1576
Phone (818) 755-8786
Other practice location 1
1150 S Olive St Ste 1400
Los Angeles, CA 90015-2871
Phone (213) 821-5977
Other practice location 2
1150 S Olive St Ste 1400
Los Angeles, CA 90015-2871
Phone (213) 821-5977
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
| License | State | Type | Specialty |
|---|---|---|---|
| 113391 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1205485125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6736 LAUREL CANYON BLVD STE 200",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916061576",
"telephone_number": "818-755-8786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6736 LAUREL CANYON BLVD STE 200",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916061576",
"telephone_number": "818-755-8786"
}
],
"practiceLocations": [
{
"address_1": "1150 S Olive St Ste 1400",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900152871",
"country_code": "US",
"telephone_number": "213-821-5977",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1150 S Olive St Ste 1400",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900152871",
"country_code": "US",
"telephone_number": "213-821-5977",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAVEZ",
"first_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-04",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "113391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.