Mari Ann Fortuna, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18829 Issued in CA

Practice address

4311 Wilshire Blvd Ste 504
Los Angeles, CA 90010-3717

Phone

(323) 960-0321

NPI assigned

Jun 21, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1649764754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 WILSHIRE BLVD STE 504",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103717",
            "telephone_number": "323-960-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 WILSHIRE BLVD STE 504",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103717",
            "telephone_number": "323-960-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 W Sierra Madre Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Sierra Madre",
            "state": "CA",
            "postal_code": "910243017",
            "country_code": "US",
            "telephone_number": "323-960-0321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "MARI ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "18829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gage Fortney-Henriquez
• Derek Ryan Fortney
• Annie Leola Fortson
• Paula Fortson
• Rupert Fortugaleza, FNP
• Maria Delia Dejarme Fortunato, PMHNP-BC
• Forum Medical Group
• Forward Recovery Solutions, LLC
• Forward Recovery Solutions, LLC
• Forward Urology Medical Group Apc

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, 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 Jun 21, 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.