Jesica Lorena Ixtlahuac

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

ASW119408 Issued in CA

Practice address

3200 Motor Ave
Los Angeles, CA 90034-3740

Phone

(310) 836-1223

NPI assigned

Apr 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Amanecer Community Counseling Service, a Non-Profit Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1053449900
  NPD (past)

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1689425019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343740",
            "telephone_number": "323-742-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343740",
            "telephone_number": "310-836-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IXTLAHUAC",
        "first_name": "JESICA",
        "middle_name": "LORENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW119408",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "ASW119408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Iwata, DDS
• Doris Iwuagwu
• Thelma Obiagaliaku Iwuchukwu Godslaw, OTR/L
• Miracle Ossynakachukwu Iwuchukwu-Godslaw
• Tonya Kelli Ixta-Howard, LPT
• Eimar Ixtlilco
• Iyashi Wellness
• Geeta Varadraj Iyengar, M.D.
• Mahima Iyengar, MD
• Mangala Sridhar Iyengar, MD/PHD

• School Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• School Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.