Individual provider Active NPI

Ana Gabriela Campos, MSW

  • Clinical Social Worker
  • Cerritos, CA
National Provider Identifier
1528342953
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68433 Issued in CA
Practice address
17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone
(562) 402-0688
Fax
(562) 402-3032
NPI assigned
Oct 4, 2011
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW31223 CA
Clinical Social Worker 1041C0700X 68433 CA Primary

Addresses

Primary practice location

17707 Studebaker Rd
Cerritos, CA 90703-2640

Mailing address

17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone (562) 402-0688

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
I20190424001769 CA Practitioner - Clinical Social Worker 4385986264 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

Practice addresses (Care Compare)

17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone (562) 467-0209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW31223CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Mar 4, 2019 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Mar 4, 2019 Accepting new patients

Locations

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1528342953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688",
            "fax_number": "562-402-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "ANA",
        "middle_name": "GABRIELA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW31223",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "68433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.