Active NPI
Alexandra Banuelos
- Clinical Social Worker
- Lynwood, CA
National Provider Identifier
1346996972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 96790
- Practice address
- 2640 Industry Way
Lynwood, CA 90262-4284 - Phone
- (310) 627-4525
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 96790 | CA | |
| Clinical Social Worker | 1041C0700X | 96790 | CA | Primary |
Addresses
Primary practice location
2640 Industry Way
Lynwood, CA 90262-4284
Mailing address
2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-4525
Other practice location 1
1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159
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 |
|---|---|---|---|
| 96790 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1346996972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 INDUSTRY WAY",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902624284",
"telephone_number": "310-627-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2640 INDUSTRY WAY",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902624284",
"telephone_number": "310-627-4525"
}
],
"practiceLocations": [
{
"address_1": "1301 Pine Ave",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908133124",
"country_code": "US",
"telephone_number": "562-595-1159",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANUELOS",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-22",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "96790",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "96790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.