Individual provider Active NPI

Monica Alexandra Rivera Vazquez, MSW

  • Clinical Social Worker
  • Santa Ana, CA
National Provider Identifier
1235645532
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
82591 Issued in CA
Practice address
1207 E Fruit St
Santa Ana, CA 92701-4206
Phone
(646) 369-8310
NPI assigned
Dec 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 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 82591 CA Primary

Addresses

Primary practice location

1207 E Fruit St
Santa Ana, CA 92701-4206

Mailing address

1207 E Fruit St
Santa Ana, CA 92701-4206
Phone (646) 369-8310

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
82591CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix House Orange County, Inc Past Accepting new patients

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1235645532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "646-369-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "646-369-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA VAZQUEZ",
        "first_name": "MONICA",
        "middle_name": "ALEXANDRA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.