Individual provider Active NPI

Marlen Bonilla Amador

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1659115699
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122871 Issued in CA
Practice address
808 W 58TH St
Los Angeles, CA 90037-3632
Phone
(323) 541-1600
Fax
(323) 541-1661
NPI assigned
Jun 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 122871 CA Primary

Addresses

Primary practice location

808 W 58TH St
Los Angeles, CA 90037-3632

Mailing address

1025 W 93Rd St
Los Angeles, CA 90044-3317
Phone (424) 454-8142

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

NPI Registry JSON

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1659115699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W 93RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900443317",
            "telephone_number": "424-454-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-541-1600",
            "fax_number": "323-541-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA AMADOR",
        "first_name": "MARLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "122871",
            "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 Jun 24, 2024; 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.