Individual provider Active NPI

Veronica J Davalos

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1851556435
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65479 Issued in CA
Practice address
3711 Long Beach Blvd
Ste. 600
Long Beach, CA 90807-3315
Phone
(562) 216-2174
Fax
(562) 981-7569
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 65479 CA Primary

Addresses

Primary practice location

3711 Long Beach Blvd
Ste. 600
Long Beach, CA 90807-3315

Mailing address

3711 Long Beach Blvd
Ste. 600
Long Beach, CA 90807-3315
Phone (562) 216-2174

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
I20201216000864 CA Practitioner - Clinical Social Worker 7719399708 Reassigns benefits to 2 organizations
Practice locations: La Quinta, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Medical Center Tehachapi CurrentSince Feb 15, 2021 Accepting new patients
County of Inyo CurrentSince Jan 24, 2023 Accepting new patients
County of Inyo Current Accepting new patients
Adventist Health Medical Center Tehachapi CurrentSince Feb 15, 2021 Accepting new patients
The Guidance Center Past Accepting new patients

Locations

1360 N Main St
Ste 124
Bishop, CA 93514
Phone (760) 872-2590

9350 N Loop Blvd
California City, CA 93505
Phone (760) 373-1785

1100 Magellan Dr
Tehachapi, CA 93561
Phone (661) 823-3000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1851556435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD",
            "address_2": "STE. 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073315",
            "telephone_number": "562-216-2174",
            "fax_number": "562-981-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 LONG BEACH BLVD",
            "address_2": "STE. 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073315",
            "telephone_number": "562-216-2174",
            "fax_number": "562-981-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVALOS",
        "first_name": "VERONICA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "65479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.