Individual provider Active NPI

Debora Azucena Legarreta, M.S.W

  • Clinical Social Worker
  • Palmdale, CA
National Provider Identifier
1689943516
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW101865 Issued in CA
Practice address
1529 E Palmdale Blvd
Palmdale, CA 93550-2034
Phone
(661) 575-1800
NPI assigned
Dec 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCSW101865 CA Primary

Addresses

Primary practice location

1529 E Palmdale Blvd
Palmdale, CA 93550-2034

Mailing address

1529 E Palmdale Blvd Ste 150
Palmdale, CA 93550-2038
Phone (661) 575-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW101865CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Jun 4, 2021 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jun 4, 2021 Accepting new patients

Locations

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

1529 E Palmdale Blvd
Ste 150
Palmdale, CA 93550
Phone (661) 575-1800

Organizations & group practices 3

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": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1689943516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502038",
            "telephone_number": "661-575-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502034",
            "telephone_number": "661-575-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGARRETA",
        "first_name": "DEBORA",
        "middle_name": "AZUCENA",
        "name_prefix": "Mrs.",
        "credential": "M.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW101865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.