NPIMap

Individual provider Active NPI

Juan Carlos Mejia, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1295860955
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW75500 Issued in CA
Practice address
1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015
Phone
(323) 000-2404
Fax
(213) 947-4565
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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 LCSW75500 CA Primary

Addresses

Primary practice location

1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015

Mailing address

1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015-3809
Phone (323) 999-2404

Other practice location 1

100 E Wardlow Rd
Long Beach, CA 90807-4417
Phone (562) 427-6818

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
LCSW75500CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1295860955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 W OLYMPIC BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153809",
            "telephone_number": "323-999-2404",
            "fax_number": "213-947-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W OLYMPIC BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90015",
            "telephone_number": "323-000-2404",
            "fax_number": "213-947-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Wardlow Rd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908074417",
            "country_code": "US",
            "telephone_number": "562-427-6818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW75500",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 3, 2018; 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.