Active NPI
Nestor Isai Pacheco
- Social Worker
- Los Angeles, CA
National Provider Identifier
1336838903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW114264
- Practice address
- 1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015-3865 - Phone
- (323) 999-2404
- NPI assigned
- May 1, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 114264 | CA | |
| Social Worker | 104100000X | ASW114264 | CA | Primary |
Addresses
Primary practice location
1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015-3865
Mailing address
1625 W Olympic Blvd Ste 600
Los Angeles, CA 90015-3865
Phone (323) 999-2404
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW114264 | CA | MD | Social Worker |
| 114264 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1336838903",
"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": "900153865",
"telephone_number": "323-999-2404"
},
{
"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": "900153865",
"telephone_number": "323-999-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "NESTOR",
"middle_name": "ISAI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-01",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "114264",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW114264",
"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 Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.