Individual provider Active NPI

Jaime Arevalo Becerril, ACSW

  • Clinical Social Worker
  • Van Nuys, CA
National Provider Identifier
1295192755
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW60416 Issued in CA
Practice address
16360 Roscoe Blvd FL 2NF
Van Nuys, CA 91406-1219
Phone
(818) 901-4830
NPI assigned
Jan 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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 ASW60416 CA Primary

Addresses

Primary practice location

16360 Roscoe Blvd FL 2NF
Van Nuys, CA 91406-1219

Mailing address

PO Box 1565
Rancho Cucamonga, CA 91729-1565
Phone (909) 989-5699

Other names 1

  • Jaime Becerril Arevalo Other name

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
ASW60416CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1295192755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1565",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917291565",
            "telephone_number": "909-989-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16360 ROSCOE BLVD FL 2NF",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914061219",
            "telephone_number": "818-901-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRIL",
        "first_name": "JAIME",
        "middle_name": "AREVALO",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW60416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "AREVALO",
            "middle_name": "BECERRIL",
            "credential": "ACSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.