Active NPI
Raymund Ilejay
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1760931406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121722
- Practice address
- 1720 E 120TH St
Los Angeles, CA 90059-3052 - Phone
- (323) 298-3680
- NPI assigned
- Sep 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 84420 | CA | |
| Clinical Social Worker | 1041C0700X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 121722 | CA | Primary |
Addresses
Primary practice location
1720 E 120TH St
Los Angeles, CA 90059-3052
Mailing address
1720 E 120TH St
Los Angeles, CA 90059-3052
Phone (323) 298-3680
Other practice location 1
3751 Stocker St
View Park, CA 90008
Phone (323) 298-3680
Other practice location 2
1200 N Main St Ste 200
Santa Ana, CA 92701-3640
Phone (714) 480-6767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121722 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1760931406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 E 120TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900593052",
"telephone_number": "323-298-3680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 E 120TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900593052",
"telephone_number": "323-298-3680"
}
],
"practiceLocations": [
{
"address_1": "3751 Stocker St",
"address_purpose": "LOCATION",
"city": "View Park",
"state": "CA",
"postal_code": "90008",
"country_code": "US",
"telephone_number": "323-298-3680",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 N Main St Ste 200",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927013640",
"country_code": "US",
"telephone_number": "714-480-6767",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ILEJAY",
"first_name": "RAYMUND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-22",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "84420",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "121722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.