Active NPI
Danny E Potillo, ACSW
- Social Worker
- Long Beach, CA
National Provider Identifier
1407594609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 99706
- Practice address
- 5901 E 7TH St
Long Beach, CA 90822-5201 - Phone
- (562) 826-8000
- NPI assigned
- May 26, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 99706 | CA | Primary |
Addresses
Primary practice location
5901 E 7TH St
Long Beach, CA 90822-5201
Mailing address
888 W Santa Ana Blvd Ste 150
Santa Ana, CA 92701-4592
Other practice location 1
888 W Santa Ana Blvd Ste 150
Santa Ana, CA 92701-4592
Phone (714) 568-9803
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311575142 | Other | CA | DEPARTMENT OF VETERANS AFFAIRS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 99706 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1407594609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "888 W SANTA ANA BLVD STE 150",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201",
"telephone_number": "562-826-8000"
}
],
"practiceLocations": [
{
"address_1": "888 W Santa Ana Blvd Ste 150",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927014592",
"country_code": "US",
"telephone_number": "714-568-9803",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTILLO",
"first_name": "DANNY",
"middle_name": "E",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-26",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "99706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF VETERANS AFFAIRS",
"identifier": "311575142",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.