Individual provider Active NPI

Veronica Aida Mendoza

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1497007256
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
86007 Issued in CA
Practice address
4700 W Sunset Blvd
Los Angeles, CA 90027-6082
Phone
(800) 464-4000
NPI assigned
Oct 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 86007 CA Primary

Addresses

Primary practice location

4700 W Sunset Blvd
Los Angeles, CA 90027-6082

Mailing address

PO Box 933
Chino Hills, CA 91709-0032

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20181204001581 CA Practitioner - Clinical Social Worker 2264776160 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86007CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 18, 2021 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Oct 19, 2024 Accepting new patients

Locations

4700 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-2600

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1497007256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917090032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276082",
            "telephone_number": "800-464-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "VERONICA",
        "middle_name": "AIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.