Individual provider Active NPI

Marlene Jesusmaria Garcia, LCSW

  • Clinical Social Worker
  • Covina, CA
National Provider Identifier
1720248727
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29866 Issued in CA
Practice address
1359 N Grand Ave
Covina, CA 91724-1016
Phone
(626) 430-2900
NPI assigned
Jun 12, 2008
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29866 CA Primary

Addresses

Primary practice location

1359 N Grand Ave
Covina, CA 91724-1016

Mailing address

1025 W Arrow Hwy
Upland, CA 91786-4441
Phone (626) 262-6774

Other practice location 1

17707 Studebaker Rd # 208
Cerritos, CA 90703-2640
Phone (562) 402-0677

Other identifiers 1

IdentifierTypeStateIssuer
ICAN811OtherCALA COUNTY DMH

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
I20201020002643 CA Practitioner - Clinical Social Worker 1153741723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1359 N Grand Ave
FL 1
Covina, CA 91724-1016
Phone (626) 430-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29866CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
La County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 15, 2020 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 15, 2020 Accepting new patients

Locations

330 E Live Oak Ave
Arcadia, CA 91006
Phone (626) 254-1400

17707 Studebaker Rd
#208
Cerritos, CA 90703
Phone (562) 402-0677

1359 N Grand Ave
Covina, CA 91724
Phone (626) 430-2900

1359 N Grand Ave
Fl 1
Covina, CA 91724
Phone (626) 430-2900

349A E Avenue K6
Lancaster, CA 93535
Phone (661) 723-4260

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Interoperability endpoints

  • Direct secure messaging: mjgarcia@lacdmh.netsmartdirect.net

Organizations & group practices 4

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1720248727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864441",
            "telephone_number": "626-262-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241016",
            "telephone_number": "626-430-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17707 Studebaker Rd # 208",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907032640",
            "country_code": "US",
            "telephone_number": "562-402-0677",
            "fax_number": "562-467-7478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MARLENE",
        "middle_name": "JESUSMARIA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA COUNTY DMH",
            "identifier": "ICAN811",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.