Active NPI
Brent Eli McCloud
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1265781926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 333 S Beaudry Ave
Los Angeles, CA 90017-1466 - Phone
- (213) 241-3841
- Fax
- (213) 241-3305
- NPI assigned
- Sep 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Mailing address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841
Other practice location 1
3756 Santa Rosalia Dr Ste 628
Los Angeles, CA 90008-3606
Phone (323) 293-8771
Other practice location 2
3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 836-1223
Other practice location 3
8929 S. Sepulveda Blvd,
Los Angeles, CA 90045
Phone (310) 922-7953
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265781926 | Other | CA | VISTA DEL MAR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1265781926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 S BEAUDRY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171466",
"telephone_number": "213-241-3841",
"fax_number": "213-241-3305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 S BEAUDRY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171466",
"telephone_number": "213-241-3841",
"fax_number": "213-241-3305"
}
],
"practiceLocations": [
{
"address_1": "3756 Santa Rosalia Dr Ste 628",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900083606",
"country_code": "US",
"telephone_number": "323-293-8771",
"fax_number": "323-293-8780",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3200 Motor Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900343710",
"country_code": "US",
"telephone_number": "310-836-1223",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8929 S. Sepulveda Blvd,",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90045",
"country_code": "US",
"telephone_number": "310-922-7953",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLOUD",
"first_name": "BRENT",
"middle_name": "ELI",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-09",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISTA DEL MAR",
"identifier": "1265781926",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.