Individual provider Active NPI

Adriel K Nganwuchu

  • Clinical Social Worker
  • View Park, CA
National Provider Identifier
1306223607
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
99512 Issued in CA
Practice address
5300 Angeles Vista Blvd
View Park, CA 90043-1648
Phone
(323) 295-4555
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Clinical Social Worker 1041C0700X 99512 CA Primary

Addresses

Primary practice location

5300 Angeles Vista Blvd
View Park, CA 90043-1648

Mailing address

11608 Crenshaw Blvd Apt 1
Inglewood, CA 90303-3265

Other names 1

  • Adriel K Ross Former name

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
I20210521001605 CA Practitioner - Clinical Social Worker 0840699955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815-3700
Phone (562) 961-0155

4800 E Los Coyotes Diagonal
Long Beach, CA 90815-2897
Phone (562) 506-1313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1306223607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11608 CRENSHAW BLVD APT 1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903033265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ANGELES VISTA BLVD",
            "city": "VIEW PARK",
            "state": "CA",
            "postal_code": "900431648",
            "telephone_number": "323-295-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGANWUCHU",
        "first_name": "ADRIEL",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "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": "CA",
            "license": "99512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIEL",
            "last_name": "ROSS",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in View Park, CA

Sources for this page

Verify at the official NPI Registry.