Individual provider Active NPI

Wanda Vasquez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1801052899
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125843 Issued in CA
Practice address
5700 Wilshire Blvd Ste 560
Los Angeles, CA 90036-5418
Phone
(213) 637-5000
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA
Clinical Social Worker 1041C0700X 125843 CA Primary

Addresses

Primary practice location

5700 Wilshire Blvd Ste 560
Los Angeles, CA 90036-5418

Mailing address

5700 Wilshire Blvd Ste 560
Los Angeles, CA 90036-5418
Phone (213) 637-5000

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

LicenseStateTypeSpecialty
125843CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamburger Home CurrentSince Sep 29, 2024 Accepting new patients

Locations

5700 Wilshire Blvd
Ste 560
Los Angeles, CA 90036
Phone (323) 574-6758

3580 Wilshire Blvd
Ste 800
Los Angeles, CA 90010
Phone (213) 361-5733

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1801052899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 WILSHIRE BLVD STE 560",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365418",
            "telephone_number": "213-637-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 WILSHIRE BLVD STE 560",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365418",
            "telephone_number": "213-637-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "WANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125843",
            "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 Sep 27, 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.

Verify at the official NPI Registry.