Individual provider Active NPI

Nicole Fiore Valencia, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1225442726
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94171 Issued in CA
Practice address
3303 N Broadway
Los Angeles, CA 90031-2803
Phone
(323) 478-8200
Fax
(323) 344-8829
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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 94171 CA Primary

Addresses

Primary practice location

3303 N Broadway
Los Angeles, CA 90031-2803

Mailing address

3303 N Broadway
Los Angeles, CA 90031-2803
Phone (323) 478-8200

Other identifiers 1

IdentifierTypeStateIssuer
94171OtherCALCSW

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210524001096 CA Practitioner - Clinical Social Worker 3678972734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 9, 2021 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 9, 2021 Accepting new patients

Locations

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

3303 N Broadway
Fl 4
Los Angeles, CA 90031
Phone (213) 308-4467

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1225442726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312803",
            "telephone_number": "323-478-8200",
            "fax_number": "323-344-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312803",
            "telephone_number": "323-478-8200",
            "fax_number": "323-344-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "NICOLE",
        "middle_name": "FIORE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "94171",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.