Individual provider Active NPI

Mayra Leon Fogg

  • Social Worker
  • Visalia, CA
National Provider Identifier
1467978981
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
132797 Issued in CA
Practice address
1830 S Central St
Visalia, CA 93277-4418
Phone
(559) 730-2969
Fax
(559) 730-2991
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 132797 CA Primary

Addresses

Primary practice location

1830 S Central St
Visalia, CA 93277-4418

Mailing address

1830 S Central St
Visalia, CA 93277-4418
Phone (559) 730-2969

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
I20260209001296 CA Practitioner - Clinical Social Worker 4385123579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3900 5TH Ave
Suite 300
San Diego, CA 92103-3138

9850 Genesee Ave
La Jolla, CA 92037-1206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
132797CAMDMarriage & Family Therapist
105890CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tulare County Office of Education CurrentSince Oct 29, 2023 Accepting new patients
Monica Perlman MD Inc. CurrentSince Jan 12, 2026 Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

1830 S Central St
Visalia, CA 93277
Phone (559) 730-2969

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": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1467978981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 S CENTRAL ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774418",
            "telephone_number": "559-730-2969",
            "fax_number": "559-730-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S CENTRAL ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774418",
            "telephone_number": "559-730-2969",
            "fax_number": "559-730-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON FOGG",
        "first_name": "MAYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "132797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.