Active NPI
Ashley Maritza Mendoza
- Clinical Social Worker
- Cerritos, CA
National Provider Identifier
1588068282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 91529
- Practice address
- 10929 South St Ste 208B
Cerritos, CA 90703-5368 - Phone
- (562) 924-5526
- NPI assigned
- Oct 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CA | ||
| Clinical Social Worker | 1041C0700X | 91529 | CA | Primary |
Addresses
Primary practice location
10929 South St Ste 208B
Cerritos, CA 90703-5368
Mailing address
1325 Western Ave
Hollywood, CA 90027
Other practice location 1
1325 N Western Ave
Los Angeles, CA 90027-5615
Phone (323) 461-3131
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 |
|---|---|---|---|
| 91529 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JWCH Institute, Inc | Past | Accepting new patients | |
| Covenant House California | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HAGGAA
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Los Angeles, CA
- NPI 1518169325
-
- Community Health Clinic/Center
- Los Angeles, CA
- NPI 1528515152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1588068282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 WESTERN AVE",
"city": "HOLLYWOOD",
"state": "CA",
"postal_code": "90027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10929 SOUTH ST STE 208B",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907035368",
"telephone_number": "562-924-5526"
}
],
"practiceLocations": [
{
"address_1": "1325 N Western Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900275615",
"country_code": "US",
"telephone_number": "323-461-3131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MENDOZA",
"first_name": "ASHLEY",
"middle_name": "MARITZA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-09",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "91529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.