Individual provider Active NPI

Juliet Baghoomian, LCSW

  • Clinical Social Worker
  • Glendale, CA
National Provider Identifier
1811605116
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111639 Issued in CA
Practice address
6444 San Fernando Rd
Glendale, CA 91201-2124
Phone
(818) 839-1687
NPI assigned
Nov 7, 2022
Reactivated
Jul 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 111639 CA Primary

Addresses

Primary practice location

6444 San Fernando Rd
Glendale, CA 91201-2124

Mailing address

PO Box 3274
Glendale, CA 91221-0274

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
I20250919004458 CA Practitioner - Clinical Social Worker 1254835317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1800 Grismer Ave
Apt 204
Burbank, CA 91504-3600

5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111639CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince Sep 5, 2025 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1811605116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3274",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912210274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012124",
            "telephone_number": "818-839-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHOOMIAN",
        "first_name": "JULIET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2025-07-30",
        "certification_date": "2024-06-04",
        "deactivation_date": "2024-06-04",
        "reactivation_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.