Active NPI
Tara Maazel, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1336782853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 110169
- Practice address
- 11835 W Olympic Blvd
Los Angeles, CA 90064-5001 - Phone
- (323) 332-9905
- NPI assigned
- Oct 28, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 110169 | CA | Primary |
Addresses
Primary practice location
11835 W Olympic Blvd
Los Angeles, CA 90064-5001
Mailing address
PO Box 88106
Los Angeles, CA 90009-8106
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110169 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sud Specialty Group - Ca | Clinical | Current | Accepting new patients |
| Jewish Family Service of Los Angeles | Past | Accepting new patients |
Locations
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428
520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295
Organizations & group practices 2
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.
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Santa Clara, CA
- NPI 1972138238
Clinical
-
- Voluntary or Charitable Agency
- Los Angeles, CA
- NPI 1144244591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1336782853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 88106",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900098106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645001",
"telephone_number": "323-332-9905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAAZEL",
"first_name": "TARA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-28",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "110169",
"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 Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.