Active NPI
Leslie Grande Hermosillo
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1306960562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 333 S Beaudry Ave
Los Angeles, CA 90017 - Phone
- (213) 241-3814
- Fax
- (213) 241-3305
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CA | ||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
333 S Beaudry Ave
Los Angeles, CA 90017
Mailing address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3814
Other practice location 1
9650 Zelzah Ave
Northridge, CA 91325
Phone (818) 993-9311 ext. 5356
Other practice location 2
333 S Beaudry Ave
Los Angeles, CA 90017
Phone (213) 241-3814
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62889 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1306960562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 S BEAUDRY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171466",
"telephone_number": "213-241-3814",
"fax_number": "213-241-3305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 S BEAUDRY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90017",
"telephone_number": "213-241-3814",
"fax_number": "213-241-3305"
}
],
"practiceLocations": [
{
"address_1": "9650 Zelzah Ave",
"address_purpose": "LOCATION",
"city": "Northridge",
"state": "CA",
"postal_code": "91325",
"country_code": "US",
"telephone_number": "818-993-9311 x5356",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "333 S Beaudry Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "90017",
"country_code": "US",
"telephone_number": "213-241-3814",
"fax_number": "213-241-3305",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERMOSILLO",
"first_name": "LESLIE",
"middle_name": "GRANDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"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 May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.