Carlos Portillo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

112333 Issued in CA

Practice address

20501 Ventura Blvd
Woodland Hills, CA 91364-2337

Phone

(818) 826-0253

Fax

(818) 975-5008

NPI assigned

Aug 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlosportillo-tarzanatreatmentcenter@lacsapc.netsmartdirect.net

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.

• Los Angeles County Department of Public Health

  • Public Health or Welfare Agency
  • Alhambra, CA
  • NPI 1700090834
  NPD
• Tarzana Treatment Centers, Inc.

  • Community/Behavioral Health Agency
  • Lancaster, CA
  • NPI 1346842093
  NPD
• Tarzana Treatment Centers, Inc.

  • Psychiatric Hospital
  • Tarzana, CA
  • NPI 1396076147
  NPD
• Tarzana Treatment Centers, Inc.

  • Multi-Specialty Clinic/Center
  • Palmdale, CA
  • NPI 1619702099
  NPD

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1679053342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20501 VENTURA BLVD STE 170",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646258",
            "telephone_number": "818-826-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20501 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642337",
            "telephone_number": "818-826-0253",
            "fax_number": "818-975-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R12361610816",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damien Rozell Pope Jr.
• Patricia Luce Pope, PH.D.
• Hesssed Porras
• Joette T Porteous, OTR
• Steven Michael Porter
• Chopana Franchesca Portillo
• Karla Portillo
• Stephanie Portillo
• Stephen Post, DPT
• Michael Potkin, D.C.

• Clinical Social Worker in Woodland Hills, CA
• Providers in Woodland Hills, 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 Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.