Individual provider Active NPI

Yudha Mann Adiputera

  • Clinical Social Worker
  • Culver City, CA
National Provider Identifier
1275014037
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW142167 Issued in CA
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(310) 390-6612
NPI assigned
Aug 28, 2018
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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 LCSW142167 CA Primary

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

2000 E 4TH St Ste 201
Santa Ana, CA 92705-3907
Phone (714) 547-0885

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
ASW110428CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service PastSince Sep 21, 2025 Accepting new patients
Telecare Corporation Past Accepting new patients
Orange County Asian and Pacific Islander Community Alliance, Inc. PastSince Oct 1, 2022 Accepting new patients
Didi Hirsch Psychiatric Service PastSince Sep 21, 2025 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1275014037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E 4TH ST STE 201",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053907",
            "telephone_number": "714-547-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADIPUTERA",
        "first_name": "YUDHA",
        "middle_name": "MANN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW142167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.