Individual provider Active NPI

Rose Jeannette Sanmiguel

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1336929835
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW119179 Issued in CA
Practice address
4927 Huntington Dr N Ste 100
Los Angeles, CA 90032-1679
Phone
(323) 221-0779
NPI assigned
Oct 2, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW119179 CA Primary
Rehabilitation Practitioner 225400000X NU

Addresses

Primary practice location

4927 Huntington Dr N Ste 100
Los Angeles, CA 90032-1679

Mailing address

940 Avenue 64
Pasadena, CA 91105-2711
Phone (323) 543-2800

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
ASW119179CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1336929835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 AVENUE 64",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052711",
            "telephone_number": "323-543-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 HUNTINGTON DR N STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900321679",
            "telephone_number": "323-221-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANMIGUEL",
        "first_name": "ROSE",
        "middle_name": "JEANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW119179",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 14, 2023; 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.