Ricardo Banuelos Jr.

Individual provider Active NPI Clinical Social Worker · Duarte, CA

NPI 1548933583 · NPPES record last updated Jan 9, 2024

Key facts

NPI
1548933583
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(626) 218-2015
NPI assigned
Jul 27, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other practice location 1

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other providers in Duarte, CA

All providers in Duarte, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.