Jezreel Martin Supetran

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

61376 Issued in CA

Practice address

1750 Heywood St Unit B
Simi Valley, CA 93065-6552

Phone

(805) 694-8368

NPI assigned

Sep 14, 2009

Last updated

Mar 16, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jezreelsupetran-lacavrccenter@lacsapc.netsmartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment
• Los Angeles County Department of Public Health

  • Public Health or Welfare Agency
  • Alhambra, CA
  • NPI 1700090834
  NPD

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1629301213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S FREMONT AVE UNIT 34",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918038867",
            "telephone_number": "626-997-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 HEYWOOD ST UNIT B",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656552",
            "telephone_number": "805-694-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPETRAN",
        "first_name": "JEZREEL",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "61376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunlight Home Health Care Inc
• Sunray Adhc, Inc.
• Sunrise Lovely Manor
• Sunrise Manor Common Lovely, LLC
• Sunset Sleep Labs LLC
• Ashley Surak, PT, DPT
• Alexis Sutton, PSYD
• Les A. Sutton, D.D.S.
• Svrtc LLC
• Haihong Dela Sierra Sy Jr., LPT

• Clinical Social Worker in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.