Individual provider Active NPI

Raizel Chaya Lax, MSW

  • Social Worker
  • Los Angeles, CA
National Provider Identifier
1588006134
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
9110 Cresta Dr
Los Angeles, CA 90035-4117
Phone
(310) 936-8978
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

9110 Cresta Dr
Los Angeles, CA 90035-4117

Mailing address

9110 Cresta Dr
Los Angeles, CA 90035-4117
Phone (310) 936-8978

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
I20201210001812 CA Practitioner - Clinical Social Worker 2668884909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Practice addresses (Care Compare)

Palm Springs, CA 92264
Phone (855) 241-7160

39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of California LLC CurrentSince Nov 8, 2020 Accepting new patients
Memory Check Psychological Services, a Professional Corporation CurrentSince Jun 6, 2022 Accepting new patients

Locations

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1588006134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9110 CRESTA DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354117",
            "telephone_number": "310-936-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 CRESTA DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354117",
            "telephone_number": "310-936-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "RAIZEL",
        "middle_name": "CHAYA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.