Active NPI
Iileene Medrano
- Clinical Social Worker
- City of Industry, CA
National Provider Identifier
1881499374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 115428
- Practice address
- 15757 E Valley Blvd
City of Industry, CA 91744-3900 - Phone
- (626) 333-3801
- Fax
- (626) 336-1303
- NPI assigned
- Feb 18, 2025
- Sex
- Female
- 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 | 115428 | CA | Primary |
Addresses
Primary practice location
15757 E Valley Blvd
City of Industry, CA 91744-3900
Mailing address
PO Box 2342
Santa Fe Springs, CA 90670-0342
Phone (323) 434-6483
Other practice location 1
PO Box 2342
Santa Fe Springs, CA 90670-0342
Phone (323) 434-6483
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 |
|---|---|---|---|
| 115428 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1881499374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2342",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906700342",
"telephone_number": "323-434-6483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15757 E VALLEY BLVD",
"city": "CITY OF INDUSTRY",
"state": "CA",
"postal_code": "917443900",
"telephone_number": "626-333-3801",
"fax_number": "626-336-1303"
}
],
"practiceLocations": [
{
"address_1": "PO Box 2342",
"address_purpose": "LOCATION",
"city": "Santa Fe Springs",
"state": "CA",
"postal_code": "906700342",
"country_code": "US",
"telephone_number": "323-434-6483",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDRANO",
"first_name": "IILEENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-18",
"last_updated": "2025-02-18",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "115428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in City of Industry, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.