Individual provider Active NPI

Iesha Rose Duncan

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1417417296
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW106513 Issued in CA
Practice address
300 UCLA Medical PLZ Ste 1100
Los Angeles, CA 90095-4820
Phone
(310) 825-9989
Fax
(310) 267-1908
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW106513 CA
Social Worker 104100000X LCSW106513 CA
Clinical Social Worker 1041C0700X LCSW106513 CA Primary

Addresses

Primary practice location

300 UCLA Medical PLZ Ste 1100
Los Angeles, CA 90095-4820

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

649 E Albertoni St Ste 100
Carson, CA 90746-1538
Phone (310) 436-9300

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
I20240320003482 CA Practitioner - Clinical Social Worker 6103263579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1880 Century Park E
Suite 614
Los Angeles, CA 90067-1622
Phone (951) 475-9620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW106513CAMDMental Health Counselor
106513CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on All Child Therapies Inc CurrentSince Apr 16, 2025 Accepting new patients
Star View Behavioral Health, Inc. Past Accepting new patients

Locations

1880 Century Park E
Ste 614
Los Angeles, CA 90067
Phone (310) 433-0467

Organizations & group practices 2

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1417417296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE 1100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900954820",
            "telephone_number": "310-825-9989",
            "fax_number": "310-267-1908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "649 E Albertoni St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Carson",
            "state": "CA",
            "postal_code": "907461538",
            "country_code": "US",
            "telephone_number": "310-436-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "IESHA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW106513",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW106513",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW106513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.