Angela Bernadette Coulter Diaz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW29650 Issued in CA

Practice address

300 UCLA Medical PLZ Ste 2200
Los Angeles, CA 90095-4006

Phone

(310) 825-9989

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

No

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

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.32 of 100Reported as group

Quality

76.01

Promoting interoperability

100

Improvement activities

40

Cost

56.17

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• UC Regents

  dba UCLA Neuropsychiatric Behavioral Health

  • Adult Development & Aging Psychologist
  • Los Angeles, CA
  • NPI 1750368999
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1487940862",
    "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 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900954006",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4073 Charles Ave",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902324006",
            "country_code": "US",
            "telephone_number": "310-383-6046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER DIAZ",
        "first_name": "ANGELA",
        "middle_name": "BERNADETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 23571",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW29650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cinzia Cottu Di Roccaforte, PSY.D.
• Delena Couchman
• Christine Ji-Hae Coughlin, D.D.S.
• Shannon E Coughlin, PT, DPT
• Thomas Bernhard Coulson II
• Kurtis Coulter
• Megan Coulter, M.A., PCCI
• Country Villa East L.P. (Country Villa East Healthcare Center)
• Country Villa East L.P. (Country Villa Terrace Healthcare Center)
• Country Villa East, L.P. (Country Villa Pavilion Healthcare Center)

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.