Maxine Mack

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122455 Issued in CA

Practice address

8215 Van Nuys Blvd
Panorama City, CA 91402-4810

Phone

(818) 855-2270

NPI assigned

Oct 6, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1457801151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8330 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244619",
            "telephone_number": "818-996-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8215 VAN NUYS BLVD",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024810",
            "telephone_number": "818-855-2270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8330 Reseda Blvd",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913244619",
            "country_code": "US",
            "telephone_number": "818-996-1051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "122455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric C. Ma, MD
• Lalaine Calinog Mabansag, DDS
• Ron Collado Macadangdang
• Lois E Macdonald, CRNA
• Heidi Machen, CRNA
• Andrea Mackey
• Maddatu Dental Corporation
• Buenaventura Tabayoyong Madriaga Jr., RCP
• Stephanie Ayroso Madridejos, FNP-C, FNP-BC
• Maga Home Health, Inc.

• Clinical Social Worker in Panorama City, CA
• Providers in Panorama City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.