Individual provider Active NPI

Lisa Cortez, LCSW

  • Clinical Social Worker
  • Modesto, CA
National Provider Identifier
1235539859
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88137 Issued in CA
Practice address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone
(209) 567-4766
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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 88137 CA Primary

Addresses

Primary practice location

2215 Blue Gum Ave
Modesto, CA 95358-1052

Mailing address

916 McHenry Ave
Modesto, CA 95350-5417

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20220119001275 CA Practitioner - Clinical Social Worker 8426440744 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Aug 9, 2025 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Mar 21, 2025 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Sep 1, 2025 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1235539859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BLUE GUM AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953581052",
            "telephone_number": "209-567-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1789 W Yosemite Ave",
            "city": "Manteca",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953375130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.