Individual provider Active NPI

Jiali Dong

  • Social Worker
  • Duarte, CA
National Provider Identifier
1316465396
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW84316 Issued in CA
Practice address
2502 E. Huntington Dr.
Duarte, CA 91010-2221
Phone
(626) 263-9133
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 84316 CA
Social Worker 104100000X ASW84316 CA Primary

Addresses

Primary practice location

2502 E. Huntington Dr.
Duarte, CA 91010-2221

Mailing address

2502 E. Huntington Dr.
Duarte, CA 91010-2221
Phone (626) 263-9133

Other practice location 1

1730 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 553-1884

Other practice location 2

1730 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 553-1884

Other practice location 3

515 Columbia Ave
Los Angeles, CA 90017
Phone (213) 553-1884

Other practice location 4

9353 Valley Blvd
Rosemead, CA 91770-1923
Phone (323) 203-9404

Other names 1

  • Jia Dong 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
ASW84316CAMDSocial Worker
84316CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1316465396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 E. HUNTINGTON DR.",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102221",
            "telephone_number": "626-263-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E. HUNTINGTON DR.",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102221",
            "telephone_number": "626-263-9133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 W Olympic Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90015",
            "country_code": "US",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1730 W Olympic Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90015",
            "country_code": "US",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90017",
            "country_code": "US",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9353 Valley Blvd",
            "address_purpose": "LOCATION",
            "city": "Rosemead",
            "state": "CA",
            "postal_code": "917701923",
            "country_code": "US",
            "telephone_number": "323-203-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONG",
        "first_name": "JIALI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "84316",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW84316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIA",
            "last_name": "DONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.