Individual provider Active NPI

Violetta Fernandez

  • Social Worker
  • Los Angeles, CA
National Provider Identifier
1609317304
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
68768 Issued in CA
Practice address
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone
(323) 233-0425
Fax
(323) 232-2366
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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 68768 CA Primary

Addresses

Primary practice location

4211 Avalon Blvd
Los Angeles, CA 90011-5622

Mailing address

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 233-0425

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
I20231107001651 CA Practitioner - Clinical Social Worker 6507213915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68768CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Sep 25, 2023 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jun 29, 2026 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

555 Marin St
Ste 180
Thousand Oaks, CA 91360
Phone (626) 701-4249

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1609317304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-233-0425",
            "fax_number": "323-232-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-233-0425",
            "fax_number": "323-232-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "VIOLETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "68768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.