Active NPI
Ernesto Maldonado
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1508172792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5201 S Vermont Ave
Los Angeles, CA 90037-3527 - Phone
- (310) 200-7516
- NPI assigned
- Aug 25, 2010
- Last updated
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary | |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
5201 S Vermont Ave
Los Angeles, CA 90037-3527
Mailing address
6462 Adobe Cir
Irvine, CA 92617-5137
Phone (714) 337-2041
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Health & Rehabilitation Program | Past | Accepting new patients | |
| Southern California Health & Rehabilitation Program | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Lynwood, CA
- NPI 1467775221
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1861521841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1508172792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6462 ADOBE CIR",
"city": "IRVINE",
"state": "CA",
"postal_code": "926175137",
"telephone_number": "714-337-2041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900373527",
"telephone_number": "310-200-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "ERNESTO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-25",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"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 Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.