Edith Adela Arevalo-Medina, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

76092 Issued in CA

Practice address

3900 E. Pacific Coast Highway
Long Beach, CA 90804

Phone

(310) 325-6542

NPI assigned

Nov 27, 2013

Last updated

Dec 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Edith Adela Arevalo Barreiro Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1689005738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E PACIFIC COAST HWY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042013",
            "telephone_number": "310-325-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E. PACIFIC COAST HIGHWAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90804",
            "telephone_number": "310-325-6542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Victoria St",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902483523",
            "country_code": "US",
            "telephone_number": "310-715-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AREVALO-MEDINA",
        "first_name": "EDITH",
        "middle_name": "ADELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EDITH",
            "last_name": "AREVALO BARREIRO",
            "middle_name": "ADELA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ubaldo Arellano, RKT
• Cristina Arenales
• Marianna Arens
• Debbie Areola
• Aldemar Arevalo Cordova, RN
• Julio Cesar Arevalo
• Monica Arevalo
• Vanessa Arevalo
• Yessenia Esmeralda Arevalo
• Sarkis T. Arevian, M.D.

• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, 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 Dec 22, 2021; 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.