Active NPI
Yesenia Medina, ACSW #96330
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1558918276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 96330
- Practice address
- 849 E 6TH St
Los Angeles, CA 90021-1026 - Phone
- (213) 623-8446
- Fax
- (213) 896-1880
- NPI assigned
- Aug 19, 2019
- Last updated
- Jun 30, 2023
- Sex
- Female
- 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 | 96330 | CA | Primary |
| Social Worker | 104100000X | 96330 | CA | |
| Clinical Social Worker | 1041C0700X | 96330 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
849 E 6TH St
Los Angeles, CA 90021-1026
Mailing address
849 E 6TH St
Los Angeles, CA 90021-1026
Phone (213) 623-8446
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 |
|---|---|---|---|
| 96330 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Para Los Ninos | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1073637567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1558918276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "849 E 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900211026",
"telephone_number": "213-623-8446",
"fax_number": "213-896-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 E 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900211026",
"telephone_number": "213-623-8446",
"fax_number": "213-896-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "YESENIA",
"credential": "ACSW #96330",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-19",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "96330",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "96330",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "96330",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"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 Jun 30, 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.