Active NPI
Javier Diaz
- Clinical Social Worker
- Pasadena, CA
National Provider Identifier
1831740877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104903
- Practice address
- 1245 E Walnut St
Pasadena, CA 91106-1878 - Phone
- (626) 773-4364
- NPI assigned
- Sep 20, 2019
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 104903 | CA | Primary |
Addresses
Primary practice location
1245 E Walnut St
Pasadena, CA 91106-1878
Mailing address
2522 Maynard Dr
Duarte, CA 91010-2213
Phone (626) 533-6060
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 |
|---|---|---|---|
| 104903 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Social Model Recovery Systems, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1497834089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1831740877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2522 MAYNARD DR",
"city": "DUARTE",
"state": "CA",
"postal_code": "910102213",
"telephone_number": "626-533-6060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 E WALNUT ST",
"city": "PASADENA",
"state": "CA",
"postal_code": "911061878",
"telephone_number": "626-773-4364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-20",
"last_updated": "2023-06-29",
"certification_date": "2023-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "104903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.