Individual provider Active NPI

Maria Amezquita

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1629445168
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
82853 Issued in CA
Practice address
4211 Avalon Blvd
Los Angeles, CA 90011
Phone
(323) 233-0425
Fax
(323) 232-2366
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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 82853 CA Primary

Addresses

Primary practice location

4211 Avalon Blvd
Los Angeles, CA 90011

Mailing address

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

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

LicenseStateTypeSpecialty
82853CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1629445168",
    "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": "90011",
            "telephone_number": "323-233-0425",
            "fax_number": "323-232-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEZQUITA",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.