Individual provider Active NPI

Rogelio Hernandez-Melendez

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1841590064
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW72959 Issued in CA
Practice address
3751 Stocker PL.
Los Angeles, CA 90008
Phone
(323) 298-3680
NPI assigned
Oct 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 28976 CA
Mental Health Counselor 101YM0800X ASW28967 CA
Clinical Social Worker 1041C0700X LCSW72959 CA Primary

Addresses

Primary practice location

3751 Stocker PL.
Los Angeles, CA 90008

Mailing address

3933 Dalton Ave
Los Angeles, CA 90062-0000
Phone (323) 236-4088

Other identifiers 1

IdentifierTypeStateIssuer
#95-2633765OtherCAMEDI-CAL

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
ASW28967CAMDMental Health Counselor
LCSW72959CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1841590064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3933 DALTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900620000",
            "telephone_number": "323-236-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 STOCKER PL.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90008",
            "telephone_number": "323-298-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-MELENDEZ",
        "first_name": "ROGELIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-22",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "28976",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW28967",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW72959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "#95-2633765",
            "state": "CA"
        }
    ],
    "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 9, 2016; 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.