Individual provider Active NPI

Pamela L. Jophryn-Avila

  • Social Worker
  • Palmdale, CA
National Provider Identifier
1366844391
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW125474 Issued in CA
Practice address
2260 E Palmdale Blvd Ste J
Palmdale, CA 93550-4952
Phone
(661) 575-8000
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 00727993 CA
Rehabilitation Practitioner 225400000X 8919 CA
Social Worker 104100000X ASW125474 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8219 CA

Addresses

Primary practice location

2260 E Palmdale Blvd Ste J
Palmdale, CA 93550-4952

Mailing address

44554 Benald St
Lancaster, CA 93535-3438
Phone (562) 212-6473

Other practice location 1

16360 Roscoe Blvd Fl 2
Van Nuys, CA 91406-1219
Phone (818) 901-4830 ext. 3229

Other practice location 2

526 S San Pedro St
Los Angeles, CA 90013-2102
Phone (213) 488-9559

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
ASW125474CAMDSocial Worker
00727993CAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Lamp Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1366844391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44554 BENALD ST",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935353438",
            "telephone_number": "562-212-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 E PALMDALE BLVD STE J",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504952",
            "telephone_number": "661-575-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16360 Roscoe Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914061219",
            "country_code": "US",
            "telephone_number": "818-901-4830 x3229",
            "fax_number": "818-901-8985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "526 S San Pedro St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900132102",
            "country_code": "US",
            "telephone_number": "213-488-9559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOPHRYN-AVILA",
        "first_name": "PAMELA",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "00727993",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "8919",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW125474",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "8219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.