Individual provider Active NPI

Krista Barrett Renta, ASW, MSW

  • Clinical Social Worker
  • Carson, CA
National Provider Identifier
1669594271
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW 24307 Issued in CA
Practice address
460 E Carson Plaza Dr
Suite 102
Carson, CA 90746-3228
Phone
(310) 523-9500
Fax
(310) 225-2725
NPI assigned
Apr 4, 2007
Last updated
Mar 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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 ASW 24307 CA Primary

Addresses

Primary practice location

460 E Carson Plaza Dr
Suite 102
Carson, CA 90746-3228

Mailing address

13424 Reva Cir
Cerritos, CA 90703-8920
Phone (562) 212-5040

Other identifiers 2

IdentifierTypeStateIssuer
00007570MedicaidCA
CBSC582OtherCALA DMH PROVIDER

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
ASW 24307CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1669594271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13424 REVA CIR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038920",
            "telephone_number": "562-212-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 E CARSON PLAZA DR",
            "address_2": "SUITE 102",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463228",
            "telephone_number": "310-523-9500",
            "fax_number": "310-225-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTA",
        "first_name": "KRISTA",
        "middle_name": "BARRETT",
        "name_prefix": "Mrs.",
        "credential": "ASW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 24307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007570",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA DMH PROVIDER",
            "identifier": "CBSC582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.