Individual provider Active NPI

Daniel A Zarate Lustre, LCSW

  • Clinical Social Worker
  • North Hollywood, CA
National Provider Identifier
1710322821
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
95506 Issued in CA
Practice address
12821 Victory Blvd
North Hollywood, CA 91606-3012
Phone
(818) 432-5025
NPI assigned
May 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 F5073237 CA
Clinical Social Worker 1041C0700X 95506 CA Primary

Addresses

Primary practice location

12821 Victory Blvd
North Hollywood, CA 91606-3012

Mailing address

12821 Victory Blvd
North Hollywood, CA 91606-3012
Phone (818) 432-5025

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: Yes
  • 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
F5073237CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1710322821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12821 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063012",
            "telephone_number": "818-432-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063012",
            "telephone_number": "818-432-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARATE LUSTRE",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "F5073237",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "95506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.