Active NPI
Roberto Murillo, MASTER SOCIAL WORK
- Social Worker
- Los Angeles, CA
National Provider Identifier
1417774571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 714 S Fetterly Ave
Los Angeles, CA 90022-2520 - Phone
- (323) 363-4832
- NPI assigned
- Sep 20, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 93055 | CA | |
| Social Worker | 104100000X | CA | Primary |
Addresses
Primary practice location
714 S Fetterly Ave
Los Angeles, CA 90022-2520
Mailing address
714 S Fetterly Ave
East Los Angeles, CA 90022-2520
Phone (323) 363-4832
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 |
|---|---|---|---|
| 93055 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1417774571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 S FETTERLY AVE",
"city": "EAST LOS ANGELES",
"state": "CA",
"postal_code": "900222520",
"telephone_number": "323-363-4832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 S FETTERLY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900222520",
"telephone_number": "323-363-4832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURILLO",
"first_name": "ROBERTO",
"credential": "MASTER SOCIAL WORK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-20",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "93055",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": null,
"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 Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.