Individual provider Active NPI

Irene Munoz

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1275809824
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101757 Issued in CA
Practice address
11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Phone
(310) 966-6500
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 101757 CA Primary
Mental Health Counselor 101YM0800X ASW84312 CA
Social Worker 104100000X ASW84312 CA
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

Mailing address

12440 Imperial Hwy
Norwalk, CA 90650-3177

Other practice location 1

12440 Imperial Hwy Ste 116
Norwalk, CA 90650-8347
Phone (562) 565-6471

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
I20230531000655 CA Practitioner - Clinical Social Worker 1759748197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11080 W Olympic Blvd
Edmund Edelman
Los Angeles, CA 90064-1937
Phone (310) 966-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW84312CAMDMental Health Counselor
101757CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Feb 8, 2023 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 8, 2023 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients

Locations

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

11080 W Olympic Blvd
Los Angeles, CA 90064
Phone (310) 966-6500

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1275809824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 IMPERIAL HWY",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937",
            "telephone_number": "310-966-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12440 Imperial Hwy Ste 116",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906508347",
            "country_code": "US",
            "telephone_number": "562-565-6471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101757",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW84312",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW84312",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.