Active NPI
Ebony Watson
- Clinical Social Worker
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW112959
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW112959 | CA | MD | Clinical Social Worker |
| 225400000 | CA | MD | Rehabilitation Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Healthcare | Current | Accepting new patients | |
| Sud Specialty Group - Ca | Clinical | Current | Accepting new patients |
| Neighborhood Healthcare | Current | Accepting new patients | |
| Neighborhood Healthcare | Past | Accepting new patients | |
| Neighborhood Healthcare | Past | 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.
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1598703647
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Santa Clara, CA
- NPI 1972138238
Clinical
-
- Federally Qualified Health Center (FQHC)
- Beaumont, CA
- NPI 1629601653
-
- Federally Qualified Health Center (FQHC)
- Hemet, CA
- NPI 1154786846
-
- Federally Qualified Health Center (FQHC)
- Riverside, CA
- NPI 1447847207
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.