Matthew Kijak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111179 Issued in CA

Practice address

1701 N Avenue 56
Los Angeles, CA 90042-1118

Phone

(909) 451-9901

NPI assigned

Jun 2, 2022

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• South Coast Children's Society, Inc

  dba Hope Healing Connection

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mission Viejo, CA
  • NPI 1083503577
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1518606953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N AVENUE 56",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421118",
            "telephone_number": "909-451-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N AVENUE 56",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421118",
            "telephone_number": "909-451-9901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 W Foothill Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917868007",
            "country_code": "US",
            "telephone_number": "877-527-7227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 N Indian Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917114614",
            "country_code": "US",
            "telephone_number": "818-288-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIJAK",
        "first_name": "MATTHEW",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW93903",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111179",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerad Kightlinger Harris, MD
• Danylo Kihiczak, MD
• E Douglas Kihn, O.M.D., L.AC.
• Kiira Health Practice Ca PC
• Kiiro Group
• Kiki L Hurt, MD Apc
• Robin Kikuchi
• Lisa Kil, OTR/L
• Suha Kilani
• Barbara Kilbert-Mackson

• 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 Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.