Jesenya Guadalupe Borunda Maldonado

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

129711 Issued in CA

Practice address

5628 E. Slauson Ave
City of Commerce, CA 90040

Phone

(323) 318-9960

Fax

(323) 780-3211

NPI assigned

Aug 5, 2020

Reactivated

Jan 17, 2024

Last updated

Apr 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Penny Lane Centers

  • Community/Behavioral Health Agency
  • North Hollywood, CA
  • NPI 1447597489
  NPD (past)

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1902416787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 E. SLAUSON AVE",
            "city": "CITY OF COMMERCE",
            "state": "CA",
            "postal_code": "90040",
            "telephone_number": "323-318-3423",
            "fax_number": "323-780-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5628 E. SLAUSON AVE",
            "city": "CITY OF COMMERCE",
            "state": "CA",
            "postal_code": "90040",
            "telephone_number": "323-318-9960",
            "fax_number": "323-780-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUNDA MALDONADO",
        "first_name": "JESENYA",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "deactivation_date": "2024-01-10",
        "reactivation_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129711",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "95-2633765",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "95-2633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enki Health Services, Inc
• Shanthi Ravi Iyer
• Karla Sandin

• Clinical Social Worker in City of Commerce, CA
• Providers in City of Commerce, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.