NPIMap

Organization Active NPI

Lausd 97TH St SMH Clinic

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1902034101
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0315 Issued in CA
Legal business name
LAUSD 97TH ST SMH CLINIC
Practice address
439 W 97TH St
Los Angeles, CA 90003-3968
Phone
(323) 754-2856
Fax
(323) 754-1843
NPI assigned
Jun 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Pia Escudero
Title
Director
Phone
(213) 241-3841

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0315 CA Primary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X

Addresses

Primary practice location

439 W 97TH St
Los Angeles, CA 90003-3968

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other identifiers 1

IdentifierTypeStateIssuer
0315OtherCALA CTY ENTITY

National Provider Directory

National Provider Directory
Tax ID family
Lausd 97TH St Valleysmh7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1902034101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 W 97TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900033968",
            "telephone_number": "323-754-2856",
            "fax_number": "323-754-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUSD 97TH ST SMH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "ESCUDERO",
        "authorized_official_first_name": "PIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-241-3841"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "0315",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CTY ENTITY",
            "identifier": "0315",
            "state": "CA"
        }
    ],
    "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 Jun 25, 2009; 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.