Active NPI
Daniel A Zarate Lustre, LCSW
- Clinical Social Worker
- North Hollywood, CA
National Provider Identifier
1710322821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 95506
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F5073237 | CA | MD | Mental 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.