Active NPI
Ray Maldonado, ASW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1376060541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 710 E 111TH PL
Los Angeles, CA 90059-1518 - Phone
- (323) 233-0425
- NPI assigned
- Aug 28, 2017
- Last updated
- Jun 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | Primary | ||
| School Social Worker | 1041S0200X |
Addresses
Primary practice location
710 E 111TH PL
Los Angeles, CA 90059-1518
Mailing address
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 233-0425
Other practice location 1
3800 S Figueroa St
Los Angeles, CA 90037-1206
Phone (323) 515-7024
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kedren Community Mental Health Center | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1134336811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1376060541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 AVALON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115622",
"telephone_number": "323-233-0425",
"fax_number": "323-232-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 E 111TH PL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900591518",
"telephone_number": "323-233-0425"
}
],
"practiceLocations": [
{
"address_1": "3800 S Figueroa St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900371206",
"country_code": "US",
"telephone_number": "323-515-7024",
"fax_number": "323-232-2366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALDONADO",
"first_name": "RAY",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-28",
"last_updated": "2023-06-27",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"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 Jun 27, 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.