Individual provider Active NPI

Brendan Marquez, ASW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1710347364
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94688 Issued in CA
Practice address
3881 S Western Ave
Los Angeles, CA 90062-1105
Phone
(626) 254-5000
NPI assigned
Feb 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 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 94688 CA Primary
Mental Health Counselor 101YM0800X 70580 CA

Addresses

Primary practice location

3881 S Western Ave
Los Angeles, CA 90062-1105

Mailing address

100 N Brand Blvd
Ste 223
Glendale, CA 91203-2641
Phone (626) 254-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115000557 CA Practitioner - Clinical Social Worker 0547617433 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70580CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Self Care Counseling Marriage Family and Child Therapy Inc. Mental Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

100 N Brand Blvd
Ste 223
Glendale, CA 91203
Phone (213) 347-4740

1910 W Sunset Blvd
Ste 400
Los Angeles, CA 90026
Phone (213) 347-4356

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1710347364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BRAND BLVD",
            "address_2": "STE 223",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032641",
            "telephone_number": "626-254-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3881 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621105",
            "telephone_number": "626-254-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "BRENDAN",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-24",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94688",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "70580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.