Individual provider Active NPI

Mayra Alejandra Rosales, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1376916031
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110412 Issued in CA
Practice address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone
(213) 241-3841
Fax
(213) 241-3305
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 67388 CA
Mental Health Counselor 101YM0800X 103608 CA
Social Worker 104100000X 67388 CA
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 110412 CA Primary

Addresses

Primary practice location

333 S Beaudry Ave
Los Angeles, CA 90017-1466

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other practice location 1

118 S Oak Knoll Ave
Pasadena, CA 91101-2611
Phone (626) 993-3000

Other practice location 2

5628 E Slauson Ave
Commerce, CA 90040-2922
Phone (323) 318-9960

Other practice location 3

1501 Hughes Way
Long Beach, CA 90810-1876
Phone (310) 221-6336

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20240723003816 CA Practitioner - Clinical Social Worker 7911443247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103608CAMDMental Health Counselor
67388CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 11, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince May 11, 2024 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

12501 Imperial Hwy
Ste 400
Norwalk, CA 90650
Phone (562) 807-6100

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1376916031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 S Oak Knoll Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911012611",
            "country_code": "US",
            "telephone_number": "626-993-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5628 E Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900402922",
            "country_code": "US",
            "telephone_number": "323-318-9960",
            "fax_number": "323-780-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Hughes Way",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908101876",
            "country_code": "US",
            "telephone_number": "310-221-6336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "MAYRA",
        "middle_name": "ALEJANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "67388",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "103608",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "67388",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "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.