Individual provider Active NPI

Ebony Watson

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1689006793
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW112959 Issued in CA
Practice address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone
(213) 241-3841
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 225400000 CA
Clinical Social Worker 1041C0700X LCSW112959 CA Primary

Addresses

Primary practice location

333 S Beaudry Ave
Los Angeles, CA 90017-1466

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

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
I20230630001727 CA Practitioner - Clinical Social Worker 4688033186 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW112959CAMDClinical Social Worker
225400000CAMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Mar 24, 2025 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Aug 1, 2025 Accepting new patients
Neighborhood Healthcare CurrentSince Mar 24, 2025 Accepting new patients
Neighborhood Healthcare Past Accepting new patients
Neighborhood Healthcare PastSince Jan 1, 2021 Accepting new patients

Locations

215 S Hickory St
Escondido, CA 92025
Phone (619) 354-3833

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

4371 Latham St
Ste 200
Riverside, CA 92501

4371 Latham St
#200
Riverside, CA 92501

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

Organizations & group practices 5

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1689006793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "EBONY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "225400000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW112959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.