Individual provider Active NPI

Noemi Hernandez Kim, ACSW

  • Clinical Social Worker
  • West Covina, CA
National Provider Identifier
1225642143
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ACSW131035 Issued in CA
Practice address
1107 S Glendora Ave
West Covina, CA 91790-4923
Phone
(626) 653-9913
NPI assigned
Sep 8, 2020
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ACSW131035 CA Primary
Day Training/Habilitation Specialist 373H00000X CA
Student in an Organized Health Care Education/Training Program 390200000X
Rehabilitation Practitioner 225400000X
Community Health Worker 172V00000X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1107 S Glendora Ave
West Covina, CA 91790-4923

Mailing address

1107 S Glendora Ave
West Covina, CA 91790-4923
Phone (626) 653-9913

Other practice location 1

801 W 70th St
Los Angeles, CA 90044-5218
Phone (323) 242-5000

Other practice location 2

11601 S Western Ave
Los Angeles, CA 90047-5006
Phone (323) 242-5000

Other practice location 3

1515 W Cameron Ave Ste 218
West Covina, CA 91790-2726
Phone (626) 653-9913

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

LicenseStateTypeSpecialty
ACSW131035CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1225642143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917904923",
            "telephone_number": "626-653-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917904923",
            "telephone_number": "626-653-9913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W 70th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900445218",
            "country_code": "US",
            "telephone_number": "323-242-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11601 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900475006",
            "country_code": "US",
            "telephone_number": "323-242-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 W Cameron Ave Ste 218",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902726",
            "country_code": "US",
            "telephone_number": "626-653-9913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ KIM",
        "first_name": "NOEMI",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ACSW131035",
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "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": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.