Brenda Jeanette Cisneros

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW107694 Issued in CA

Practice address

14500 Roscoe Blvd Ste 400
Panorama City, CA 91402-4194

Phone

(800) 764-8981

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  NPD

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1700253317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 ROSCOE BLVD STE 400",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024194",
            "telephone_number": "800-764-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 ROSCOE BLVD STE 400",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024194",
            "telephone_number": "800-764-8981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12450 Van Nuys Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Pacoima",
            "state": "CA",
            "postal_code": "913311391",
            "country_code": "US",
            "telephone_number": "818-896-8366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "BRENDA",
        "middle_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW73239",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW107694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chong Ku Chun, LAC ACUPUNCTURIST
• Anna Hyunhee Chung, PHARM.D
• Delphine Chung, MD
• In-Kook Chung, MD
• Young K. Chung, MD
• Civana Treatment Center Inc
• CKC Acupuncture, Inc
• James Robert Clark
• Russell J. Clayton, MD
• Mary Bernadette Acuna Coburn, NP

• Clinical Social Worker in Panorama City, CA
• Providers in Panorama City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.

Verify at the official NPI Registry.