Individual provider Active NPI

Nereida Carrasco

  • Clinical Social Worker
  • Pasadena, CA
National Provider Identifier
1497061428
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW31479 Issued in CA
Practice address
1845 N Fair Oaks Ave
Pasadena, CA 91103-1620
Phone
(626) 744-6353
Fax
(626) 744-6335
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X D1306741 CA
Social Worker 104100000X ASW31479 CA
Clinical Social Worker 1041C0700X ASW31479 CA Primary
Clinical Social Worker 1041C0700X 71158 CA

Addresses

Primary practice location

1845 N Fair Oaks Ave
Pasadena, CA 91103-1620

Mailing address

1845 N Fair Oaks Ave
Pasadena, CA 91103-1620
Phone (626) 744-6353

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
I20210318002405 CA Practitioner - Clinical Social Worker 5890102842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family ClinicGroup PAC ID 2264339126, 101 clinicians

Practice addresses (Care Compare)

4700 Inglewood Blvd
Suite 102
Culver City, CA 90230-5896
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291-2767
Phone (310) 664-7901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW31479CAMDSocial Worker
D1306741CAMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic Current Accepting new patients
Los Angeles County Department of Public Health Current Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Dec 8, 2020 Accepting new patients
Venice Family Clinic CurrentSince Dec 8, 2020 Accepting new patients

Locations

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • Direct secure messaging: nereidacarrasco-cityofpasadena@lacsapc.netsmartdirect.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1497061428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031620",
            "telephone_number": "626-744-6353",
            "fax_number": "626-744-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031620",
            "telephone_number": "626-744-6353",
            "fax_number": "626-744-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "NEREIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "D1306741",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW31479",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW31479",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "71158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.