Individual provider Active NPI

Kaoma Yajayra Garcia, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1891292470
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117388 Issued in CA
Practice address
8019 Compton Ave
Los Angeles, CA 90001-3409
Phone
(323) 586-7333
Fax
(951) 394-7426
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 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 117388 CA Primary

Addresses

Primary practice location

8019 Compton Ave
Los Angeles, CA 90001-3409

Mailing address

8019 Compton Ave
Los Angeles, CA 90001-3409
Phone (323) 586-7333

Other practice location 1

3576 Arlington Ave Ste 100
Riverside, CA 92506-3907
Phone (951) 394-7426

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
I20241213003052 CA Practitioner - Clinical Social Worker 1254867245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loma Linda University Medical CenterGroup PAC ID 8325099138, 19 clinicians

Practice addresses (Care Compare)

1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117388CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Loma Linda University Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Loma Linda University Medical Center CurrentSince Dec 1, 2024 Accepting new patients

Locations

11234 Anderson St
#1153
Loma Linda, CA 92350

28078 Baxter Rd
Ste 240
Murrieta, CA 92563
Phone (951) 290-6530

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1891292470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013409",
            "telephone_number": "323-586-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013409",
            "telephone_number": "323-586-7333",
            "fax_number": "951-394-7426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3576 Arlington Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925063907",
            "country_code": "US",
            "telephone_number": "951-394-7426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "KAOMA",
        "middle_name": "YAJAYRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "117388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.