Active NPI
Ariel Reyes
- Clinical Social Worker
- Gardena, CA
National Provider Identifier
1508338484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 116558
- Practice address
- 108 W Victoria St
Gardena, CA 90248-3523 - Phone
- (310) 715-2020
- NPI assigned
- Dec 17, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 116558 | CA | Primary |
Addresses
Primary practice location
108 W Victoria St
Gardena, CA 90248-3523
Mailing address
PO Box 1012
South Gate, CA 90280-1012
Phone (213) 453-3773
Other practice location 1
1900 Sycamore Canyon Rd
San Dimas, CA 91773-1220
Phone (909) 599-2391
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116558 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camp Glen Rockey | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Residential Treatment Facility
- San Dimas, CA
- NPI 1841443918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1508338484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1012",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "902801012",
"telephone_number": "213-453-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W VICTORIA ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483523",
"telephone_number": "310-715-2020"
}
],
"practiceLocations": [
{
"address_1": "1900 Sycamore Canyon Rd",
"address_purpose": "LOCATION",
"city": "San Dimas",
"state": "CA",
"postal_code": "917731220",
"country_code": "US",
"telephone_number": "909-599-2391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYES",
"first_name": "ARIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "116558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.