Individual provider Active NPI

Katelyn Marie De la Rosa Aceves, LCSW

  • Clinical Social Worker
  • Pasadena, CA
National Provider Identifier
1225700636
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128994 Issued in CA
Practice address
1520 N Raymond Ave BLDG 2-7
Pasadena, CA 91103-1819
Phone
(626) 396-5920
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X ASW103335 CA
Social Worker 104100000X ASW103335 CA
Clinical Social Worker 1041C0700X 128994 CA Primary

Addresses

Primary practice location

1520 N Raymond Ave BLDG 2-7
Pasadena, CA 91103-1819

Mailing address

PO Box 1382
Alhambra, CA 91802-1382
Phone (626) 434-5687

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
ASW103335CAMDMental Health Counselor
128994CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Unified School District CurrentSince Oct 10, 2021 Accepting new patients

Locations

1520 N Raymond Ave
Bldg 27
Pasadena, CA 91103
Phone (626) 396-5920

Organizations & group practices 1

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1225700636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1382",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918021382",
            "telephone_number": "626-434-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N RAYMOND AVE BLDG 2-7",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031819",
            "telephone_number": "626-396-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA ACEVES",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW103335",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW103335",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "128994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.