Individual provider Active NPI

Maria G Avitia, LCSW

  • Social Worker
  • Los Angeles, CA
National Provider Identifier
1851632061
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone
(323) 728-0411
NPI assigned
Mar 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 120538 CA
Social Worker 104100000X Primary

Addresses

Primary practice location

5425 Pomona Blvd
Los Angeles, CA 90022-1716

Mailing address

5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone (323) 728-0411

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
I20240410002444 CA Order and Referring Only - Clinical Social Worker 4486092392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120538CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1851632061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "323-728-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "323-728-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVITIA",
        "first_name": "MARIA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "120538",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.