Individual provider Active NPI

Yvette Kristine Diaz de Tuesta, LCSW

  • Clinical Social Worker
  • Santa Clarita, CA
National Provider Identifier
1609122795
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW75365 Issued in CA
Practice address
27201 Tourney Rd Ste 201
Santa Clarita, CA 91355-1804
Phone
(661) 899-5440
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW75365 CA Primary

Addresses

Primary practice location

27201 Tourney Rd Ste 201
Santa Clarita, CA 91355-1804

Mailing address

18505 Mayall St Unit E
Northridge, CA 91324-1421
Phone (818) 900-4186

Other practice location 1

28494 Westinghouse Pl Ste 308
Santa Clarita, CA 91355-0935
Phone (818) 900-4186

Other practice location 2

18505 Mayall St Unit E
Northridge, CA 91324-1421
Phone (818) 900-4186

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
I20170302001033 CA Practitioner - Clinical Social Worker 3375827744 Practice locations: Santa Clarita, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW75365CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics PastSince Dec 12, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1609122795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18505 MAYALL ST UNIT E",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241421",
            "telephone_number": "818-900-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27201 TOURNEY RD STE 201",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913551804",
            "telephone_number": "661-899-5440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28494 Westinghouse Pl Ste 308",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913550935",
            "country_code": "US",
            "telephone_number": "818-900-4186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18505 Mayall St Unit E",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913241421",
            "country_code": "US",
            "telephone_number": "818-900-4186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ DE TUESTA",
        "first_name": "YVETTE",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW75365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

Verify at the official NPI Registry.