Active NPI
Imelda Mejia, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1417282120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW81629
- Practice address
- 1933 S Broadway
Floor 6
Los Angeles, CA 90007 - Phone
- (213) 763-3164
- Fax
- (213) 742-7011
- NPI assigned
- Oct 14, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW81629 | CA | Primary |
Addresses
Primary practice location
1933 S Broadway
Floor 6
Los Angeles, CA 90007
Mailing address
1933 S Broadway
6TH Floor
Los Angeles, CA 90007-4501
Phone (213) 763-3164
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 |
|---|---|---|---|
| LCSW81629 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1417282120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 S BROADWAY",
"address_2": "6TH FLOOR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900074501",
"telephone_number": "213-763-3164",
"fax_number": "213-742-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1933 S BROADWAY",
"address_2": "FLOOR 6",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90007",
"telephone_number": "213-763-3164",
"fax_number": "213-742-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEJIA",
"first_name": "IMELDA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-14",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW81629",
"primary": true
}
],
"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 Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.