Individual provider Active NPI

Kusi Hilda Peralta, LCSW

  • Social Worker
  • Long Beach, CA
National Provider Identifier
1669856365
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
92052 Issued in CA
Practice address
100 E Wardlow Rd
Long Beach, CA 90807
Phone
(562) 427-6818
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 92052 CA Primary

Addresses

Primary practice location

100 E Wardlow Rd
Long Beach, CA 90807

Mailing address

100 E Wardlow Rd
Long Beach, CA 90807-4417
Phone (408) 561-6822

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
I20210818003219 CA Practitioner - Clinical Social Worker 5991100612 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Jan 5, 2022 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
San Diego American Indian Health Center Social Worker CurrentSince Jul 13, 2021 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 5, 2022 Accepting new patients

Locations

2630 1st Ave
San Diego, CA 92103
Phone (619) 234-2158

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

2602 1st Ave
Ste 105
San Diego, CA 92103

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

Organizations & group practices 4

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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1669856365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WARDLOW RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074417",
            "telephone_number": "408-561-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WARDLOW RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90807",
            "telephone_number": "562-427-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "KUSI",
        "middle_name": "HILDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "92052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.