Individual provider Active NPI

Julissa Yepez

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1871995019
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62811 Issued in CA
Practice address
1721 Griffin Ave
Los Angeles, CA 90031-3312
Phone
(323) 221-4134
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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
Clinical Social Worker 1041C0700X 62811 CA Primary

Addresses

Primary practice location

1721 Griffin Ave
Los Angeles, CA 90031-3312

Mailing address

8166 Virginia Ave
South Gate, CA 90280-2408

Other practice location 1

21520 Pioneer Blvd Ste 110
Hawaiian Gardens, CA 90716-2604
Phone (562) 207-4272 ext. 152

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
62811CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871995019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8166 VIRGINIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 GRIFFIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900313312",
            "telephone_number": "323-221-4134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21520 Pioneer Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Hawaiian Gardens",
            "state": "CA",
            "postal_code": "907162604",
            "country_code": "US",
            "telephone_number": "562-207-4272 x152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEPEZ",
        "first_name": "JULISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "62811",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 17, 2018; 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.