Individual provider Active NPI

Cristina Carrera I, MSW

  • Clinical Social Worker
  • Lakewood, CA
National Provider Identifier
1801007752
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 25053 Issued in CA
Practice address
5150 Candlewood St Ste 4a
Lakewood, CA 90712-1925
Phone
(323) 379-6887
Fax
(562) 444-7057
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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 LCS 25053 CA Primary

Addresses

Primary practice location

5150 Candlewood St Ste 4a
Lakewood, CA 90712-1925

Mailing address

12907 Lariat LN
Norwalk, CA 90650-3315
Phone (323) 379-6887

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
I20150402000654 CA Practitioner - Clinical Social Worker 6204153133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 25053CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince Jan 13, 2015 Accepting new patients
Special Service for Groups, Inc. CurrentSince Jan 13, 2015 Accepting new patients
Personalized Care for Families Clinical CurrentSince Aug 9, 2020 Accepting new patients

Locations

5150 Candlewood St
Ste 4A
Lakewood, CA 90712
Phone (323) 379-6887

600 St Paul Ave
Ste 101
Los Angeles, CA 90017
Phone (213) 483-3000

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

19401 S Vermont Ave
Ste A200
Torrance, CA 90502

Interoperability endpoints

  • Direct secure messaging: cristina.carreralcsw.p1@direct.jwch.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1801007752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12907 LARIAT LN",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503315",
            "telephone_number": "323-379-6887",
            "fax_number": "562-444-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 CANDLEWOOD ST STE 4A",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121925",
            "telephone_number": "323-379-6887",
            "fax_number": "562-444-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERA",
        "first_name": "CRISTINA",
        "name_prefix": "Ms.",
        "name_suffix": "I",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 25053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.