Active NPI
Juan Manuel Pedroza Reys, LBSW
- Social Worker
- Phoenix, AZ
National Provider Identifier
1780387464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LBSW-18803
- Practice address
- 3807 N 7TH St
Phoenix, AZ 85014-5005 - Phone
- (602) 258-6797
- NPI assigned
- Mar 23, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LBSW-18803 | AZ | Primary |
Addresses
Primary practice location
3807 N 7TH St
Phoenix, AZ 85014-5005
Mailing address
8242 W Clarendon Ave
Phoenix, AZ 85033-3427
Phone (602) 931-0917
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 |
|---|---|---|---|
| LBSW-18803 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1780387464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8242 W CLARENDON AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850333427",
"telephone_number": "602-931-0917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 N 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850145005",
"telephone_number": "602-258-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDROZA REYS",
"first_name": "JUAN",
"middle_name": "MANUEL",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-23",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LBSW-18803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.