Individual provider Active NPI

Juan Leyva Garcia Jr., MSW, ASW

  • Clinical Social Worker
  • Stockton, CA
National Provider Identifier
1710008735
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW69500 Issued in CA
Practice address
42 N. Sutter Street
Suite 500
Stockton, CA 95202
Phone
(209) 933-1255
Fax
(209) 444-8920
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 15587 CA
Clinical Social Worker 1041C0700X LCSW69500 CA Primary

Addresses

Primary practice location

42 N. Sutter Street
Suite 500
Stockton, CA 95202

Mailing address

42 N. Sutter Street
Suite 500
Stockton, CA 95202
Phone (209) 933-1255

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
ASW 15587CAMDClinical Social Worker
LCSW69500CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1710008735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 N. SUTTER STREET",
            "address_2": "SUITE 500",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95202",
            "telephone_number": "209-933-1255",
            "fax_number": "209-444-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N. SUTTER STREET",
            "address_2": "SUITE 500",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95202",
            "telephone_number": "209-933-1255",
            "fax_number": "209-444-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JUAN",
        "middle_name": "LEYVA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, ASW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 15587",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW69500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.