Individual provider Active NPI

Bertha Janet Menjivar, LCSW 80277

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1801171228
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW80277 Issued in CA
Practice address
3200 Motor Ave
Los Angeles, CA 90034-3710
Phone
(310) 980-2637
NPI assigned
Oct 17, 2011
Last updated
Dec 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 31081 CA
Clinical Social Worker 1041C0700X LCSW80277 CA Primary

Addresses

Primary practice location

3200 Motor Ave
Los Angeles, CA 90034-3710

Mailing address

3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 980-2637

Other names 1

  • Ms. Bertha Janet Molina Professional name

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
I20240503002867 CA Practitioner - Clinical Social Worker 9537509765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family ClinicGroup PAC ID 2264339126, 101 clinicians

Practice addresses (Care Compare)

2509 Pico Blvd
Santa Monica, CA 90405-1828
Phone (310) 664-7901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31081CAMDClinical Social Worker
LCSW80277CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic CurrentSince Mar 10, 2024 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Mar 10, 2024 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic Current Accepting new patients

Locations

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1801171228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343710",
            "telephone_number": "310-980-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343710",
            "telephone_number": "310-980-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENJIVAR",
        "first_name": "BERTHA",
        "middle_name": "JANET",
        "name_prefix": "Mrs.",
        "credential": "LCSW 80277",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "31081",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW80277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERTHA",
            "last_name": "MOLINA",
            "middle_name": "JANET",
            "prefix": "MS.",
            "credential": "MSW, ASW 31081",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.