Active NPI
Jackie Agboke
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1467717124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 86357
- Practice address
- 757 Westwood PLZ FL 4
Los Angeles, CA 90095-3051 - Phone
- (310) 267-9190
- NPI assigned
- Jul 9, 2012
- 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 | 86357 | CA | Primary |
Addresses
Primary practice location
757 Westwood PLZ FL 4
Los Angeles, CA 90095-3051
Mailing address
757 Westwood Plaza
4 West
Los Angeles, CA 90095-3051
Phone (310) 267-9190
Other practice location 1
1721 E 120th St Trlr 6
Los Angeles, CA 90059-3051
Phone (323) 242-5000
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 |
|---|---|---|---|
| 86357 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569024000000",
"number": "1467717124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLAZA",
"address_2": "4 WEST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900953051",
"telephone_number": "310-267-9190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ FL 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900953051",
"telephone_number": "310-267-9190"
}
],
"practiceLocations": [
{
"address_1": "1721 E 120th St Trlr 6",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900593051",
"country_code": "US",
"telephone_number": "323-242-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGBOKE",
"first_name": "JACKIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-09",
"last_updated": "2019-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "86357",
"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 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.