Individual provider Active NPI

Alexandro Valdivia

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1366195778
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
96203 Issued in CA
Practice address
929 S Rowan Ave
Los Angeles, CA 90023-2413
Phone
(626) 487-6325
NPI assigned
Jan 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 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 92603 CA
Clinical Social Worker 1041C0700X 96203 CA Primary

Addresses

Primary practice location

929 S Rowan Ave
Los Angeles, CA 90023-2413

Mailing address

929 S Rowan Ave
Los Angeles, CA 90023-2413
Phone (626) 487-6325

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL N/A Other
CONNECT URL N/A Other

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310002113 CA Order and Referring Only - Clinical Social Worker 8426443318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
92603CAMDClinical Social Worker
96203CAMDMassage Therapist

Interoperability endpoints

  • Direct secure messaging: alexandro.valdivia.p3@direct.parktreechc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1366195778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 S ROWAN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232413",
            "telephone_number": "626-487-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 S ROWAN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232413",
            "telephone_number": "626-487-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIA",
        "first_name": "ALEXANDRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "92603",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "929 S Rowan Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900232413",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "929 S Rowan Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900232413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.