Individual provider Active NPI

Cynthia Matsuura

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1689122889
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
99985 Issued in CA
Practice address
8019 Compton Ave
Los Angeles, CA 90001-3409
Phone
(323) 586-7333
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 99985 CA Primary

Addresses

Primary practice location

8019 Compton Ave
Los Angeles, CA 90001-3409

Mailing address

8019 S. Compton Ave.
Los Angeles, CA 90001
Phone (323) 586-7333

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
I20230301000866 CA Practitioner - Clinical Social Worker 6709259369 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99985CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc Clinical CurrentSince Jan 1, 2023 Accepting new patients
Center for New Directions, Inc. Mental Health CurrentSince Jan 1, 2023 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

Organizations & group practices 2

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": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689122889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 S. COMPTON AVE.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-586-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013409",
            "telephone_number": "323-586-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUURA",
        "first_name": "CYNTHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "99985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.