Individual provider Active NPI

Martin Ayala, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1881811420
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28221 Issued in CA
Practice address
4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209
Phone
(323) 267-3400
Fax
(323) 978-2371
NPI assigned
Apr 18, 2007
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 28221 CA Primary

Addresses

Primary practice location

4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209

Mailing address

2512 Giovanne Way
West Covina, CA 91792-5701
Phone (626) 222-0911

Other identifiers 2

IdentifierTypeStateIssuer
00007302MedicaidCA
CBSC709OtherCALA DMH PROVIDER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140124000500 CA Practitioner - Clinical Social Worker 2567690308 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28221CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Jan 17, 2022 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jan 25, 2025 Accepting new patients

Locations

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

510 S Vermont Ave
Fl 17
Los Angeles, CA 90020
Phone (213) 332-1097

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

550 S Vermont Ave
Fl 6
Los Angeles, CA 90020
Phone (213) 351-7284

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1881811420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 GIOVANNE WAY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917925701",
            "telephone_number": "626-222-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 E CESAR E CHAVEZ AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221209",
            "telephone_number": "323-267-3400",
            "fax_number": "323-978-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007302",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA DMH PROVIDER",
            "identifier": "CBSC709",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.