Individual provider Active NPI

Erick Rubio

  • Clinical Social Worker
  • East Los Angeles, CA
National Provider Identifier
1366817470
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127671 Issued in CA
Practice address
4816 E 3Rd St
East Los Angeles, CA 90022-1602
Phone
(323) 780-4510
NPI assigned
Dec 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 90206 CA
Clinical Social Worker 1041C0700X 127671 CA Primary
Mental Health Counselor 101YM0800X 90206 CA

Addresses

Primary practice location

4816 E 3Rd St
East Los Angeles, CA 90022-1602

Mailing address

PO Box 213
La Puente, CA 91747-0213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90206CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gracelight Community Health CurrentSince Nov 23, 2024 Accepting new patients
Gracelight Community Health CurrentSince Nov 23, 2024 Accepting new patients
Childnet Youth and Family Services Inc Past Accepting new patients
Allyson Wells MD Inc PastSince Oct 19, 2020 Accepting new patients

Locations

4816 E 3rd St
Los Angeles, CA 90022
Phone (323) 780-4510

150 N Reno St
Los Angeles, CA 90026
Phone (213) 380-7298

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1366817470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 213",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917470213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 E 3RD ST",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900221602",
            "telephone_number": "323-780-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "ERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90206",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "127671",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "90206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.