Individual provider Active NPI

Miguel Romero

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1689186009
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80105 Issued in CA
Practice address
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Phone
(424) 454-6042
NPI assigned
Oct 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 80105 CA Primary

Addresses

Primary practice location

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Mailing address

5015 Kinsie St
Commerce, CA 90040-1209
Phone (323) 559-4219

Other practice location 1

5015 Kinsie St
Commerce, CA 90040-1209
Phone (323) 559-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80105CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1689186009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 KINSIE ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401209",
            "telephone_number": "323-559-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "424-454-6042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5015 Kinsie St",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900401209",
            "country_code": "US",
            "telephone_number": "323-559-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80105",
            "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 Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.