Individual provider Active NPI

Johnny Perez, LCSW

  • Clinical Social Worker
  • Castaic, CA
National Provider Identifier
1629595673
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
132464 Issued in CA
Practice address
29340 The Old Rd
Castaic, CA 91384-2905
Phone
(661) 257-5404
NPI assigned
Aug 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 778-R CA
Addiction (Substance Use Disorder) Counselor 101YA0400X C061540620 CA
Clinical Social Worker 1041C0700X 132464 CA Primary

Addresses

Primary practice location

29340 The Old Rd
Castaic, CA 91384-2905

Mailing address

19338 Welby Way
Reseda, CA 91335-4921
Phone (562) 686-5866

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
I20260420002957 CA Practitioner - Clinical Social Worker 2668948274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
778-RCAMDAddiction (Substance Use Disorder) Counselor
C061540620CAMDAddiction (Substance Use Disorder) Counselor
132464CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grandview Foundation, Inc. Past Accepting new patients

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": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1629595673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19338 WELBY WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354921",
            "telephone_number": "562-686-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29340 THE OLD RD",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913842905",
            "telephone_number": "661-257-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOHNNY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-29",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "778-R",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C061540620",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "132464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castaic, CA

Sources for this page

Verify at the official NPI Registry.