Active NPI
Diana Moreno
- Social Worker
- Culver City, CA
National Provider Identifier
1619643509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ASW111511
- Practice address
- 4760 Sepulveda Blvd
Culver City, CA 90230-4820 - Phone
- (310) 751-5438
- NPI assigned
- Aug 19, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW111511 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | ASW111511 | CA | Primary |
Addresses
Primary practice location
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Mailing address
1328 W Manchester Ave
Los Angeles, CA 90044-2240
Phone (323) 778-9593
Other practice location 1
5000 W Sunset Blvd Fl 7
Los Angeles, CA 90027-5861
Phone (323) 361-7537
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 |
|---|---|---|---|
| ASW111511 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1619643509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 W MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900442240",
"telephone_number": "323-778-9593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-751-5438"
}
],
"practiceLocations": [
{
"address_1": "5000 W Sunset Blvd Fl 7",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900275861",
"country_code": "US",
"telephone_number": "323-361-7537",
"fax_number": "323-913-7951",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORENO",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-19",
"last_updated": "2023-06-23",
"certification_date": "2023-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW111511",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW111511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.